Provider Demographics
NPI:1174006878
Name:WHEATON, JULIE M (ARNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:WHEATON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5719 NE 75TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-1051
Mailing Address - Country:US
Mailing Address - Phone:360-241-6103
Mailing Address - Fax:
Practice Address - Street 1:400 NE MOTHER JOSEPH PL
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3200
Practice Address - Country:US
Practice Address - Phone:360-514-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60277574163WW0000X
WAAP60898509363L00000X
OR201240188RN163W00000X
OR201809507NP-PP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AG09180197OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
WARN60277574OtherWA DEPARTMENT OF HEALTH - STATE BOARD OF NURSING
WAAG60898509OtherWASHINGTON DEPARTMENT OF HEALTH - STATE BOARD OF NURSING
AG09180197OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
WARN60277574OtherWA DEPARTMENT OF HEALTH - STATE BOARD OF NURSING