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General NPI Number Information
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NPI Number | 1386125565
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Entity Type | Individual
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Provider Name | ADAM DAVID BOYD
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Gender | Male
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 11/25/2018
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Provider Practice Location Address
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Address Line | 400 WARREN AVE STE 200
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City | BREMERTON
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State | WA
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Zip | 98337-1467
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Country | US
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Telephone | 360-377-3776
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Fax |
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Provider Business Mailing Address
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Address Line | MEDEX NORTHWEST, 4311 11TH AVENUE NE SUITE 200
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City | SEATTLE
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State | WA
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Zip | 98105
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 60908256
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License Number State | WA
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