Individual
MR. BO FOULKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9809 34TH AVE SW, SEATTLE, WA 98126-4134
(206) 937-6402
Mailing address
9809 34TH AVE SW, SEATTLE, WA 98126-4134
(206) 937-6402
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00046582
WA
Other
Enumeration date
07/19/2008
Last updated
07/19/2008
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