Provider Demographics
NPI:1336945328
Name:PADILLA, JULIA ANNE (MA61651429)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ANNE
Last Name:PADILLA
Suffix:
Gender:
Credentials:MA61651429
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 W NOB HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-5104
Mailing Address - Country:US
Mailing Address - Phone:206-636-2674
Mailing Address - Fax:
Practice Address - Street 1:2508 W NOB HILL BLVD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-5104
Practice Address - Country:US
Practice Address - Phone:206-636-2674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61651429111N00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No111N00000XChiropractic ProvidersChiropractor