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General NPI Number Information
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NPI Number | 1376506311
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Entity Type | Individual
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Provider Name | CHARLES A. BOYD PA-C; MPAS
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 1660 S COLUMBIAN WAY MS-111ONC
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City | SEATTLE
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State | WA
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Zip | 98108-1532
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Country | US
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Telephone | 206-227-1220
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Fax |
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Provider Business Mailing Address
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Address Line | 3021 17TH AVE S
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City | SEATTLE
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State | WA
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Zip | 98144-5804
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA10001652
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License Number State | WA
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