Basic Information
| Provider Information | |||||||||
| NPI: | 1174553184 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHUAN | ||||||||
| FirstName: | JULIE | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | MS 315010 | ||||||||
| Address2: | PO BOX 3947 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7605855460 | ||||||||
| FaxNumber: | 8584342112 | ||||||||
| Practice Location | |||||||||
| Address1: | 1035 116TH AVE NE | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607372000 | ||||||||
| FaxNumber: | 7607372039 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 01/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A80130 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QS0010X | MD60361317W | WA | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207Q00000X | MD60361317 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1598703647 | 01 | CA | CCS PANELED | OTHER | 2029414 | 05 | WA | MEDICAID |