Individual
GARY L BOOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
915 ANDERSON DR, ABERDEEN, WA 98520-1006
(360) 532-8830
Mailing address
915 ANDERSON DR, ABERDEEN, WA 98520-1006
(360) 532-8830
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA60037894
WA
Other
Enumeration date
11/17/2006
Last updated
10/17/2016
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