Individual
DONALD ALAN BOUTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
314 MARTIN LUTHER KING JR WAY, SUITE 104, TACOMA, WA 98405-4250
(253) 403-5432
Mailing address
314 MARTIN LUTHER KING JR WAY, SUITE 104, TACOMA, WA 98405-4250
(253) 403-5432
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD00025494
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7096845
—
WA
Enumeration date
09/19/2005
Last updated
01/30/2012
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