Individual
JOSHUA D BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1200 SALMON CREEK LN, JUNEAU, AK 99801-7861
(907) 463-4040
Mailing address
3100 CHANNEL DR STE 300, JUNEAU, AK 99801-7837
(907) 463-4074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
197774
AK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1736687
—
AK
01
—
197774
STATE OF ALASKA
AK
Enumeration date
07/19/2016
Last updated
06/12/2023
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