Provider Demographics
NPI:1922492008
Name:KOERNER, JULIA (MOT)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:
Last Name:KOERNER
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 S DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2905
Mailing Address - Country:US
Mailing Address - Phone:206-779-6035
Mailing Address - Fax:
Practice Address - Street 1:1903 S DEARBORN ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2905
Practice Address - Country:US
Practice Address - Phone:206-779-6035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60523196225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist