Individual
MRS. NINO BOISSONNEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
307 S. 13TH STREET, SUITE 300, SKAGIT REGIONAL CLINICS - CARDIOLOGY, MOUNT VERNON, WA 98274
(360) 336-9757
(360) 814-5237
Mailing address
1400 E. KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60257982
WA
363AM0700X
Medical Physician Assistant
PA60257982
WA
363AS0400X
Surgical Physician Assistant
PA60257982
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2016681
—
WA
Enumeration date
04/26/2010
Last updated
02/04/2015
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