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Individual
MARK W BOEDE
Active
Individual
MARK W BOEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0213610
DEPT. OF LABOR & INDUSTRY
WA
01
—
0251421
L&I
WA
01
—
0273078
DEPT L/I
WA
01
—
0309BO
REGENCE
WA
01
—
1830BO
REGENCE BLUE SHIELD
WA
01
—
1838BO
REGENCE
WA
01
—
3568BO
REGENCE BLUE SHIELD
WA
01
—
7787375
AETNA
WA
01
—
8350183
DSHS
WA
05
—
8350183
—
WA
01
—
8750BO
REGENCE BLUE SHIELD
WA
01
—
8940177
L & I CRIME VICTIMS
WA
01
—
911745305-98223-C004
TRICARE
WA
01
—
P00414140
RAILROAD MEDICARE
WA
Enumeration date
04/06/2006
Last updated
01/24/2012
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