Individual
REBECCA ELIZABETH BOZEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1959 NE PACIFIC ST., SEATTLE, WA 98195-0001
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(360) 346-2192
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
60796658
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2114053
—
WA
Enumeration date
11/21/2017
Last updated
02/04/2021
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