Provider Demographics
NPI:1942061924
Name:HERRBACH, JULIE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HERRBACH
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22104 NE 23RD ST
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-4080
Mailing Address - Country:US
Mailing Address - Phone:425-362-8914
Mailing Address - Fax:
Practice Address - Street 1:22104 NE 23RD ST
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-4080
Practice Address - Country:US
Practice Address - Phone:425-362-8914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60092779163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health