Provider Demographics
NPI:1922652130
Name:MILASICH, JULIE LYNN (OTR/L, CHT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:LYNN
Last Name:MILASICH
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:LYNN
Other - Last Name:DENNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5928 N 28TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-2350
Mailing Address - Country:US
Mailing Address - Phone:253-460-0966
Mailing Address - Fax:
Practice Address - Street 1:4970 AUTO CENTER WAY
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-3328
Practice Address - Country:US
Practice Address - Phone:360-627-7768
Practice Address - Fax:360-627-8003
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003194225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand