Provider Demographics
NPI:1144835422
Name:WELLS-DRISCOLL, JULEEANN (PA-C, MHS, MS)
Entity type:Individual
Prefix:
First Name:JULEEANN
Middle Name:
Last Name:WELLS-DRISCOLL
Suffix:
Gender:F
Credentials:PA-C, MHS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13925 PAR PL NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3054
Mailing Address - Country:US
Mailing Address - Phone:208-602-3705
Mailing Address - Fax:
Practice Address - Street 1:13925 PAR PL NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-3054
Practice Address - Country:US
Practice Address - Phone:208-602-3705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-13
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61106034363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1176518OtherNCCPA