Provider Demographics
NPI:1184601379
Name:CRANTZ, JULIE Z (ARNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:Z
Last Name:CRANTZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:ZAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:33501 1ST WAY S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6208
Mailing Address - Country:US
Mailing Address - Phone:253-838-2400
Mailing Address - Fax:253-874-1637
Practice Address - Street 1:33501 1ST WAY S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6208
Practice Address - Country:US
Practice Address - Phone:253-838-2400
Practice Address - Fax:253-874-1637
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003973363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA132323OtherLABOR & INDUSTRIES
WA9618893Medicaid
CR7063OtherREGENCE
S55332Medicare UPIN
CR7063OtherREGENCE
500009712Medicare ID - Type UnspecifiedRAILROAD MEDICARE
AB10663Medicare ID - Type Unspecified