Individual
ANTHONY A BOULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 BROADWAY STE 400, SEATTLE, WA 98122-5312
(206) 215-1440
(206) 215-1441
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD00042649
WA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
MD00042649
WA
2084P0804X
Child & Adolescent Psychiatry Physician
MD00042649
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
262640
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8369795
—
WA
Enumeration date
10/17/2006
Last updated
03/17/2018
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