Provider Demographics
NPI:1013265073
Name:THOMPSON, JULIE ANN (FNP-C PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP-C PMHNP-BC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:BROWNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1601 E 4TH PLAIN BLVD BLDG 11
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-3717
Mailing Address - Country:US
Mailing Address - Phone:360-696-4061
Mailing Address - Fax:
Practice Address - Street 1:1601 E 4TH PLAIN BLVD BLDG 11
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3717
Practice Address - Country:US
Practice Address - Phone:360-696-4061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-24
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201408801NP-PP363LF0000X
CA22150363LF0000X
OR201608742NPPP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500680513Medicaid
OR1407812363OtherNORTH BEND MEDICAL CENTER GROUP NPI
OR500680513Medicaid
OR161133OtherNORTH BEND MEDICAL CENTER GROUP MEDICAID
ORR0000WFBTVOtherNORTH BEND MEDICAL CENTER GROUP MEDICARE
OR500680513Medicaid