Individual
BENJAMIN MICHAEL BOYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT, CSCS
Contact information
Practice address
2000 HEWITT AVE, SUITE 115, EVERETT, WA 98201-3600
(425) 252-3908
(425) 252-7940
Mailing address
20117 25TH DR SE, BOTHELL, WA 98012-7603
(401) 529-6589
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT01915
RI
225100000X
Physical Therapist
Primary
PT60108164
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013BO
REGENCE
WA
01
—
0253337
L&I
WA
01
—
8589996
DSHS
WA
Enumeration date
12/11/2006
Last updated
03/10/2010
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