Provider Demographics
NPI:1962459719
Name:WOOD-MCCLURE, JULIE (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:WOOD-MCCLURE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12728 19TH AVE SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6647
Mailing Address - Country:US
Mailing Address - Phone:425-252-1116
Mailing Address - Fax:425-252-1118
Practice Address - Street 1:12728 19TH AVE. SE
Practice Address - Street 2:SUITE 200
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6647
Practice Address - Country:US
Practice Address - Phone:425-252-1116
Practice Address - Fax:425-252-1118
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043863207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD00043863OtherSTATE LICENSE NUMBER
WA8409898Medicaid
WAP00190023OtherRAILROAD MEDICARE
WA0190786OtherLABOR AND INDUSTRY
H85454Medicare UPIN
WA0190786OtherLABOR AND INDUSTRY
WAG8878280Medicare PIN