Provider Demographics
NPI:1720316896
Name:KINN, JULIE TAMAR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:TAMAR
Last Name:KINN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:TAMAR
Other - Last Name:SHECTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2083 LAKEMOOR DR SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-5565
Mailing Address - Country:US
Mailing Address - Phone:408-641-5466
Mailing Address - Fax:360-628-8565
Practice Address - Street 1:677 WOODLAND SQUARE LOOP SE
Practice Address - Street 2:SUITE B 3
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1000
Practice Address - Country:US
Practice Address - Phone:408-641-5466
Practice Address - Fax:360-628-8565
Is Sole Proprietor?:No
Enumeration Date:2009-11-30
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist