Provider Demographics
NPI:1699793919
Name:CAMPBELL, JULIANA MARIE (MS, RNC, NNP)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:MARIE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS, RNC, NNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:M
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1550 N 115TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8401
Practice Address - Country:US
Practice Address - Phone:206-520-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005623363L00000X, 363LN0005X, 363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9637737Medicaid
WA0201288OtherLABOR & INDUSTRIES
WA31873COtherREGENCE BLUESHIELD
WAP94497Medicare UPIN
WAAB38707Medicare PIN
WAG8878706Medicare PIN
WA8856907Medicare ID - Type UnspecifiedSTATE MEDICARE