Provider Demographics
NPI:1245647338
Name:GEORGIU, IULIA
Entity type:Individual
Prefix:MRS
First Name:IULIA
Middle Name:
Last Name:GEORGIU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12534 SE 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3805
Mailing Address - Country:US
Mailing Address - Phone:206-356-3381
Mailing Address - Fax:425-653-0116
Practice Address - Street 1:14811 NE 11TH PL
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4224
Practice Address - Country:US
Practice Address - Phone:206-356-3381
Practice Address - Fax:425-653-0116
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA751137311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA102922Medicaid