Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT60900602 | WA |
N | 2251X0800X | Physical Therapist - Orthopedic | 0012726 | CO |
NPI | 1104232461 |
---|---|
Provider Name | Dr. Amy Boshoven |
First Address | Castle Rock, CO 80104-7813 |
Second Address | Everett, WA 98208-3743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2014 |
Last Update Date | 10/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2112951 | (05) | WA |