Anthony A Bouldin
Pediatrician Child Neurologist
600 Broadway Ste 400
Seattle
, Washington 98122-5312
Anthony A Bouldin
Pediatrician Child Neurologist
600 Broadway Ste 400
Seattle
, Washington 98122-5312
(206) 568-7043
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About
Features
Specialties
- Pediatrician
- Child Neurologist
Languages spoken
- English
Location
First Address
- Anthony A Bouldin
- Po Box 25608
- Salt Lake City, UT
- Zip : 84125-0608
- Fax : (206) 568-7043
- Phone : (206) 320-4476
Second Address
- Anthony A Bouldin
- 600 Broadway Ste 400
- Seattle, WA
- Zip : 98122-5312
- Fax : (206) 215-1441
- Phone : (206) 215-1440
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208000000X | Pediatrician | MD00042649 | WA |
| Y | 2084N0402X | Child Neurologist | MD00042649 | WA |
National Provider Identifier
| NPI | 1164503413 |
|---|---|
| Provider Name | Anthony A Bouldin |
| First Address | Salt Lake City, UT 84125-0608 |
| Second Address | Seattle, WA 98122-5312 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/10/2006 |
| Last Update Date | 17/03/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 262640 | INTERNAL ID-MOTOR VEHICLE ID (01) | |
| 8369795 | (05) | WA |
| H93328 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.