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NPI Code Detail

MEDICARE: TYSHAYNA BOGGS NP

MEDICARE:   TYSHAYNA  BOGGS  NP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP60951707WA
2363L00000XNurse PractitionerAP60951707WA

General Provider Information

NPI Number : 1538723507
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYSHAYNA BOGGS NP
Provider Business Mailing Address
First Line : 18224 6TH AVENUE CT E
Second Line :
City : SPANAWAY
State : WA
Zip : 98387-8451
Country : US
Telephone Number : 425-220-0256
Fax Number :
Provider Business Practice Location Address
First Line : 707 S GRADY WAY STE 600
Second Line :
City : RENTON
State : WA
Zip : 98057-3227
Country : US
Telephone Number : 206-823-1004
Fax Number : 206-309-3319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2019
Last Update Date : 02/10/2026

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