Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant |
NPI | 1013135680 |
---|---|
Provider Name | Mrs. Julie Ann Vernon |
First Address | Puyallup, WA 98373-1646 |
Second Address | Tacoma, WA 98409-2615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2007 |
Last Update Date | 08/07/2007 |