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NPI Code Detail

MEDICARE: MS. WANDA JEANETTE BOE LMFT

MEDICARE:  MS. WANDA JEANETTE BOE  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistLF00001411WA

General Provider Information

NPI Number : 1750508891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. WANDA JEANETTE BOE LMFT
Provider Business Mailing Address
First Line : PO BOX 1387
Second Line :
City : NORTH BEND
State : WA
Zip : 98045-1387
Country : US
Telephone Number : 425-985-2396
Fax Number : 425-888-0372
Provider Business Practice Location Address
First Line : 1420 NW GILMAN BLVD # 2118
Second Line :
City : ISSAQUAH
State : WA
Zip : 98027-5394
Country : US
Telephone Number : 425-985-2396
Fax Number : 425-888-0372
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 02/26/2023

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Directions to “ MS. WANDA JEANETTE BOE LMFT” Practice Location

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