person
Jefferson L Boulet, PAC
Medical Physician Assistant in Buckley, Washington
NPI 1740274745

Jefferson L Boulet is a Medical Physician Assistant based in Buckley, WA and is specialized in Medical. Jefferson L Boulet practices in Buckley, WA and has the professional credentials of PAC. The NPI Number for Jefferson L Boulet is 1740274745 and holds a License No. PA10003567 (Washington).

The current practice location address for Jefferson L Boulet is 305 N River Ave, Buckley, WA and can be reached out via phone at 360-829-0625 and via fax at 360-829-9860.

Location: 305 N River Ave, Buckley, WA, 98321-1268
person
Provider Profile Details
NPI Number
1740274745
Provider Name
Jefferson L Boulet
Credential
PAC
Provider Entity Type
Individual
Gender
Male
Address
305 N River Ave, Buckley, WA, 98321-1268
Phone Number
360-829-0625
Fax Number
360-829-9860
Provider Enumeration Date
09/06/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8542300 05 WA
institution
Provider Business Practice Location Address Details
Address
305 N River Ave
City
State
Zip
98321-8978
Phone Number
360-829-0625
Fax Number
360-829-9860
person
Provider Business Mailing Address Details
Address
305 N River Ave
City
State
Zip
98321-8978
Phone Number
360-829-0625
Fax Number
360-829-9860
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA10003567 (Washington)
Definition
Definition to come...
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