Provider Demographics
NPI:1487601142
Name:MAHLER, JULIE (MNT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MAHLER
Suffix:
Gender:F
Credentials:MNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 132ND ST SE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8999
Mailing Address - Country:US
Mailing Address - Phone:425-357-9380
Mailing Address - Fax:425-357-9382
Practice Address - Street 1:11700 MUKILTEO SPEEDWAY
Practice Address - Street 2:SUITE 503
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-5432
Practice Address - Country:US
Practice Address - Phone:425-349-9692
Practice Address - Fax:425-349-9694
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7758854OtherAETNA
WA4877MAOtherREGENCE BLUE SHIELD
WA8905619OtherL&I CRIME VICTIMS
WA9173MAOtherREGENCE BLUE SHIELD
WA8425126Medicaid
WA379172610OtherOWCP
WAG8879993Medicare PIN
WA7758854OtherAETNA
WA8425126Medicaid