Provider Demographics
NPI:1902026230
Name:EKE, JULIAN EMEKA (PTA)
Entity Type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:EMEKA
Last Name:EKE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3332 DAYBREAK AVE.EAST,
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98424-3896
Mailing Address - Country:US
Mailing Address - Phone:253-709-7161
Mailing Address - Fax:
Practice Address - Street 1:3332 DAYBREAK AVE. EAST,
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98424-3896
Practice Address - Country:US
Practice Address - Phone:253-709-7161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAAPTA 203117174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist