Provider Demographics
NPI:1992814081
Name:PARNELL, JULIE (PT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:PARNELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15436 BEL RED RD
Mailing Address - Street 2:STE 100
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5536
Mailing Address - Country:US
Mailing Address - Phone:425-644-4100
Mailing Address - Fax:425-644-4101
Practice Address - Street 1:9617 7TH AVE SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3710
Practice Address - Country:US
Practice Address - Phone:425-513-8509
Practice Address - Fax:425-290-9774
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003685225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8383838Medicaid
WA0165642OtherL&I
WA8383838Medicaid