Provider Demographics
NPI:1700820644
Name:ADAMS, JULIE KAREN (PHD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:KAREN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 164TH ST SE
Mailing Address - Street 2:# 318
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6385
Mailing Address - Country:US
Mailing Address - Phone:425-379-5065
Mailing Address - Fax:425-379-0548
Practice Address - Street 1:543 MAIN ST
Practice Address - Street 2:STE 104
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3162
Practice Address - Country:US
Practice Address - Phone:425-513-1600
Practice Address - Fax:206-915-0141
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPY00001981103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7117781Medicaid
WA7117781Medicaid