Healthcare Provider Details

I. General information

NPI: 1972382547
Provider Name (Legal Business Name): DAWN KELLIE BOYD RN, BSN, MIDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAWN KELLIE VARNEY RN, BSN, MIDA

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 09/25/2023
Certification Date: 09/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11620 52ND AVE SE
EVERETT WA
98208-8707
US

IV. Provider business mailing address

11620 52ND AVE SE
EVERETT WA
98208-8707
US

V. Phone/Fax

Practice location:
  • Phone: 541-531-3019
  • Fax:
Mailing address:
  • Phone: 541-531-3019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: