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Individual

KYLE M BOGUSZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
22180 OLYMPIC COLLEGE WAY NW STE 102, POULSBO, WA 98370-6664
(360) 779-4444
(360) 697-2514
Mailing address
22180 OLYMPIC COLLEGE WAY NW STE 102, POULSBO, WA 98370-6664
(360) 779-4444
(360) 697-2514

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OP61555946
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2299844
WA
Enumeration date
04/06/2021
Last updated
11/08/2024
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