Doctor Name: | MRS. JULIETTE EILEEN POHL-Y-BACA |
NPI Number: | 1003964271 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHYCIAN ASST. -CERT |
License Number: | PA1003502 |
Business Practice Address: | 233 2nd Ave S Kent, WA - 980325852 |
Business Phone Number: | 2064366380 |
Business Fax Number: | 2064366385 |
Mailing Address: | 31116 5th Way S, FEDERAL WAY |
State: | WA |
Postal Code: | 980034049 |
Phone Number: | 2538398326 |
Fax Number: | |
NPI Enumeration Date: | 01/06/2007 |
NPI Last Update Date: | 04/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA1003502 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |