Individual
DR. MARC ANTHONY BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 636-4836
(360) 636-6792
Mailing address
2110 GALLOWS RD STE D, VIENNA, VA 22182-3962
(603) 858-0047
(331) 204-0820
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0102203346
VA
2084P0800X
Psychiatry Physician
Primary
OP60942131
WA
Other
Enumeration date
06/20/2011
Last updated
05/29/2024
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