Healthcare Provider Details

I. General information

NPI: 1780596627
Provider Name (Legal Business Name): DOUGLAS BOYCE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W HOAG ST
YACOLT WA
98675-5604
US

IV. Provider business mailing address

300 W HOAG ST
YACOLT WA
98675-5604
US

V. Phone/Fax

Practice location:
  • Phone: 360-355-4191
  • Fax:
Mailing address:
  • Phone: 360-355-4191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number01166929
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: