Provider Demographics
NPI:1992734750
Name:MCMILLAN, JULIE AMBER (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:AMBER
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9621 RIDGETOP BLVD NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1780 NW MYHRE RD
Practice Address - Street 2:SUITE 2120
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8676
Practice Address - Country:US
Practice Address - Phone:360-782-3100
Practice Address - Fax:360-782-3112
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041147207VG0400X, 207VX0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8310369Medicaid
160057051OtherRAILROAD MEDICARE
WA159338OtherLABOR & INDUSTRIES
7971208OtherAETNA
4272MCOtherREGENCE BLUESHIELD
4272MCOtherREGENCE BLUESHIELD
7971208OtherAETNA
160057051OtherRAILROAD MEDICARE
BM6831122OtherDEA
H28997Medicare UPIN
G8898359Medicare PIN
WAGAB29027Medicare PIN
WAG8851919Medicare PIN
WAGAB29025Medicare PIN
WAGAB29023Medicare PIN
G8880015Medicare PIN
WA8310369Medicaid