Healthcare Provider Details

I. General information

NPI: 1629268438
Provider Name (Legal Business Name): JASON J BOYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 148TH AVE NE # B1
BELLEVUE WA
98007-3120
US

IV. Provider business mailing address

601 BROADWAY FL 7
SEATTLE WA
98122-5330
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-2600
  • Fax: 206-622-1644
Mailing address:
  • Phone: 206-386-2600
  • Fax: 206-622-1644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD60078933
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: