Provider Demographics
NPI:1174553184
Name:CHUAN, JULIE (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:CHUAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MS 315010
Mailing Address - Street 2:PO BOX 3947
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124
Mailing Address - Country:US
Mailing Address - Phone:760-585-5460
Mailing Address - Fax:858-434-2112
Practice Address - Street 1:1035 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:760-737-2000
Practice Address - Fax:760-737-2039
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80130207Q00000X
WAMD60361317W207QS0010X
WAMD60361317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1598703647OtherCCS PANELED
WA2029414Medicaid