MEDICARE: MS. MARY CATHERINE BOIRE ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	RN 51930	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144207457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY CATHERINE BOIRE ARNP

Provider Business Mailing Address
First Line	:	1991 S NUGENT RD
Second Line	:
City	:	LUMMI ISLAND
State	:	WA
Zip	:	98262-8642
Country	:	US
Telephone Number	:	360-758-7115
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 GRAND AVE
Second Line	:	6TH FLOOR
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-4048
Country	:	US
Telephone Number	:	360-676-6780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	07/08/2007

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