Provider Demographics
NPI:1295805372
Name:LOUDON, JULIE (PT,MTC, OCS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:LOUDON
Suffix:
Gender:F
Credentials:PT,MTC, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 S MAIERS RD
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-8818
Mailing Address - Country:US
Mailing Address - Phone:509-764-7246
Mailing Address - Fax:509-764-7248
Practice Address - Street 1:2200 S MAIERS RD
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-8818
Practice Address - Country:US
Practice Address - Phone:509-764-7246
Practice Address - Fax:509-764-7248
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist