Individual
MUKSARIN BOHLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2005 W MAIN ST STE 110, BATTLE GROUND, WA 98604
(360) 882-2778
(360) 604-1762
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-4896
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA173364
OR
363A00000X
Physician Assistant
Primary
PA60848187
WA
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2047312
—
WA
05
—
500690913
—
OR
Enumeration date
08/05/2015
Last updated
10/24/2018
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