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Organization
MICHAEL BOLTWOOD , INC
Active
Organization
MICHAEL BOLTWOOD , INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BOLTWOOD PHD (OWNER)
(360) 698-1321
Entity
Organization
Contact information
Practice address
6000 WHALE DANCER CT NE, SUQUAMISH, WA 98392-9648
(360) 698-1321
(360) 308-0447
Mailing address
PO BOX 2324, SILVERDALE, WA 98383-2324
(360) 698-1321
(360) 308-0447
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY00001641
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7069149
—
WA
Enumeration date
12/13/2007
Last updated
12/30/2022
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