Provider Demographics
NPI:1881949626
Name:WONG, JULIANNE E (PA)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:E
Last Name:WONG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:303-357-2559
Mailing Address - Fax:303-955-1039
Practice Address - Street 1:8510 BRYANT ST STE 320
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3845
Practice Address - Country:US
Practice Address - Phone:720-780-5599
Practice Address - Fax:303-955-1039
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL085004333363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL085004333OtherPHYSICIAN ASSISTANT LICENSE