Provider Demographics
NPI:1801294624
Name:ASTAIRE, JULIANNA MARIE (MSW)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:MARIE
Last Name:ASTAIRE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27636 MCINTOSH LOOP NE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:WA
Mailing Address - Zip Code:98346-7668
Mailing Address - Country:US
Mailing Address - Phone:425-346-0797
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:600 BROADWAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5395
Practice Address - Country:US
Practice Address - Phone:206-302-2600
Practice Address - Fax:206-302-2610
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
390200000X
WALW609311301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program