Individual
RICHARD E BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2100 THRESHER AVE, USS NEVADA, SILVERDALE, WA 98315
(360) 315-4208
(360) 396-4247
Mailing address
3524 NW PRINCETON LN, 14-102, SILVERDALE, WA 98383
(360) 620-0276
(360) 396-4247
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/19/2006
Last updated
07/08/2007
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