Individual
JOHN W BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 9TH AVE, MS M4-PA, SEATTLE, WA 98101-2756
(206) 583-6025
(206) 515-5886
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
Primary
MD00016100
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039575
LABOR & INDUSTRY
WA
01
—
220013529
RAILROAD MEDICARE
—
01
—
804194900
IDAHO MEDICAID
WA
05
—
8381204
—
WA
01
—
B460
BLUE SHIELD
WA
01
—
MD6100W
ALASKA MEDICAID
WA
01
—
US0861403
AETNA/USHC SPECIALIST
WA
Enumeration date
07/13/2006
Last updated
06/17/2008
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