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NPI Code Detail

MEDICARE: MARNIE BOYER PA

MEDICARE: MARNIE BOYER PA
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
1363AM0700XMedical Physician AssistantPA10004142WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10156841OTHERWAWA L&I

General Provider Information

NPI Number : 1780698365
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARNIE BOYER PA
Provider Business Mailing Address
First Line : 903 S ADAMS ST
Second Line :
City : RITZVILLE
State : WA
Zip : 99169-2227
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 903 S ADAMS ST
Second Line :
City : RITZVILLE
State : WA
Zip : 99169-2227
Country : US
Telephone Number : 509-659-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 07/24/2015

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Directions to “ MARNIE BOYER PA” Practice Location

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