Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP61083174 | WA |
NPI | 1023642261 |
---|---|
Provider Name | Julia Carolyn Bokma Parker |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Seattle, WA 98104-1380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2020 |
Last Update Date | 18/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023642261 | (05) | WA |