Basic Information
| Provider Information | |||||||||
| NPI: | 1386835817 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNETT | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 712 98TH DR NE | ||||||||
| Address2: | |||||||||
| City: | LAKE STEVENS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982581645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064848228 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16550 177TH AVE SE | ||||||||
| Address2: | PO BOX 777 | ||||||||
| City: | MONROE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607842829 | ||||||||
| FaxNumber: | 3607942871 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | 37469 | TX | N | Pharmacy Service Providers | Pharmacist | Pharmacotherapy | 207Q00000X | ME113462 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 208600000X | ML20008866 | WA | N | Allopathic & Osteopathic Physicians | Surgery | 208D00000X | 45569 | AZ | N | Allopathic & Osteopathic Physicians | General Practice | 207Q00000X | MD60729698 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.