Provider Demographics
NPI:1831224229
Name:BOWMAN, JULIA K (MS RD LMHC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:K
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MS RD LMHC
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:K
Other - Last Name:TABORSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS RD LMHC
Mailing Address - Street 1:164 TENNESSEE AVE NE APT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-6475
Mailing Address - Country:US
Mailing Address - Phone:206-790-3898
Mailing Address - Fax:
Practice Address - Street 1:2001 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 211
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-3603
Practice Address - Country:US
Practice Address - Phone:571-257-3378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI0001584133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9647TAOtherBLUE SHIELD #
WA8398232Medicaid
WA8398232Medicaid