Individual
TYSHAYNA BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
707 S GRADY WAY STE 600, RENTON, WA 98057-3227
(206) 823-1004
(206) 309-3319
Mailing address
18224 6TH AVENUE CT E, SPANAWAY, WA 98387-8451
(425) 220-0256
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60951707
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP60951707
WA
Other
Enumeration date
04/25/2019
Last updated
02/10/2026
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