Provider Demographics
NPI:1194414110
Name:VAARA, JULIA MARIE HANSON (IBCLC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIE HANSON
Last Name:VAARA
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2879 N NUGENT RD APT H5
Mailing Address - Street 2:
Mailing Address - City:LUMMI ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98262-8689
Mailing Address - Country:US
Mailing Address - Phone:360-393-9845
Mailing Address - Fax:
Practice Address - Street 1:4619 NE KILLINGSWORTH ST UNIT 16
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97218-1952
Practice Address - Country:US
Practice Address - Phone:360-393-9845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL-74464174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN