Basic Information
| Provider Information | |||||||||
| NPI: | 1518196542 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JUAIRE | ||||||||
| FirstName: | NOEMIE | ||||||||
| MiddleName: | CORINNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1840 E RAY RD | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852258720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8553970197 | ||||||||
| FaxNumber: | 8002726512 | ||||||||
| Practice Location | |||||||||
| Address1: | 2707 COLBY AVE STE 718 | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982013528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253395413 | ||||||||
| FaxNumber: | 4253394213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2009 | ||||||||
| LastUpdateDate: | 11/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | MD60164168 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 2018980 | 05 | WA | MEDICAID |