Provider Demographics
NPI:1922503580
Name:GARCIA, JANICE JULY YOO (DO)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:JULY YOO
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:JULY
Other - Last Name:YOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:37624 SE FURY ST STE 101
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9680
Practice Address - Country:US
Practice Address - Phone:425-888-2016
Practice Address - Fax:206-320-5170
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61244582207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2214848Medicaid