Provider Demographics
NPI:1316080328
Name:DECUIRE, JULIE A
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:DECUIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:SKELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1519 132ND ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7203
Mailing Address - Country:US
Mailing Address - Phone:425-330-0633
Mailing Address - Fax:425-338-9637
Practice Address - Street 1:22500 NE MARKETPLACE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-2033
Practice Address - Country:US
Practice Address - Phone:425-836-1034
Practice Address - Fax:425-836-1037
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0218066OtherDEPT. OF LABOR & INDUSTRY
WA3499DEOtherREGENCE
WA7762900OtherAETNA
WA0232275OtherLABOR & INDUSTRIES
WA8943763OtherL&I CRIME VICTIMS
WAP00417127OtherRAILROAD MEDIARE
WAG8872199OtherMEDICARE
WA2250DEOtherREGENCE BLUE SHIELD
WA8474595Medicaid
WA8870905OtherMEDICARE
WAP00473358OtherRAILROAD MEDICARE
WA7762900OtherAETNA