Individual
AUTUM ROSE BOULAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 744-3000
Mailing address
6400 SOUTHCENTER BLVD, TUKWILA, WA 98188-2547
(206) 901-2000
(206) 901-2010
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/02/2017
Last updated
05/24/2019
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