Provider Demographics
NPI:1215626387
Name:BRUCE, JULIA GRACE (MSN, RDN, CD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:GRACE
Last Name:BRUCE
Suffix:
Gender:F
Credentials:MSN, RDN, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:WA
Mailing Address - Zip Code:99328-1704
Mailing Address - Country:US
Mailing Address - Phone:360-984-9390
Mailing Address - Fax:
Practice Address - Street 1:1408 S 2ND ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:WA
Practice Address - Zip Code:99328-1704
Practice Address - Country:US
Practice Address - Phone:360-984-9390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered