Provider Demographics
NPI:1932204559
Name:WOOD, JULIE DIANE (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:DIANE
Last Name:WOOD
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2426 239TH PL NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-3546
Mailing Address - Country:US
Mailing Address - Phone:425-868-1733
Mailing Address - Fax:
Practice Address - Street 1:1715 114TH AVE SE STE 208
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6906
Practice Address - Country:US
Practice Address - Phone:425-453-6220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALMHC30003298101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional