Provider Demographics
NPI:1114376613
Name:NSUBUGA, JULIETTE
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:
Last Name:NSUBUGA
Suffix:
Gender:
Credentials:
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:707 S GRADY WAY RENTON WA 98057
Mailing Address - Street 2:707 S GRADY WAY SUITE 400
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3663
Mailing Address - Country:US
Mailing Address - Phone:972-206-7087
Mailing Address - Fax:844-651-3846
Practice Address - Street 1:707 S GRADY WAY RENTON WA 98057
Practice Address - Street 2:707 S GRADY WAY SUITE 400
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-3663
Practice Address - Country:US
Practice Address - Phone:972-206-7087
Practice Address - Fax:844-651-3846
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP61664202363LF0000X
TXAP130938363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily