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General NPI Number Information
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NPI Number | 1659153138
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Entity Type | Organization
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Legal Business Name | BOKELYN HEALTH ASSOCIATES
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Dates
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Enumeration Date | 10/18/2023
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 809 W MAIN ST STE C
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City | MONROE
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State | WA
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Zip | 98272-2172
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Country | US
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Telephone | 405-532-0876
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Fax |
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Provider Business Mailing Address
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Address Line | 17501 OAK ST GRANITE FALLS
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City | GRANITE FALLS
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State | WA
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Zip | 98252-8998
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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 | ARNP
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Name | LINETTE MAUYA
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Credential | PMHNP
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Telephone | 405-532-0876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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