Individual
AUDRA ALEXANDRA BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8745 PACIFIC AVE NW # 102, SILVERDALE, WA 98383-8394
(602) 045-1223
Mailing address
8745 PACIFIC AVE NW # 102, SILVERDALE, WA 98383-8394
(602) 045-1223
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DE61663002
WA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
MD61663011
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/08/2019
Last updated
07/14/2025
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