Provider Demographics
NPI:1154993012
Name:PHAM, JULIA (NP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:PHAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2475 140TH AVE. NE
Mailing Address - Street 2:BUILDING C
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005
Mailing Address - Country:US
Mailing Address - Phone:253-376-0011
Mailing Address - Fax:
Practice Address - Street 1:7530 164TH AVE. NE
Practice Address - Street 2:SUITE A215
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052
Practice Address - Country:US
Practice Address - Phone:425-885-9292
Practice Address - Fax:425-885-9106
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61118494163W00000X
CA95022153363LP2300X
WAAP61430159363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care