Individual
JAMES TRAVIS BOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
9115 BRIDGEPORT WAY SW STE 2, LAKEWOOD, WA 98499-2449
(253) 393-9099
Mailing address
302 CHAMPION ST, STEILACOOM, WA 98388-1108
(915) 730-4282
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
61590376
WA
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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