Stacey Noel Boomer PA-C

NPI 1790835932 - Physician Assistant - 363A00000X

NPI Details
NPI 1790835932
Gender Female
Enumeration Date 01/11/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
400 E 5TH AVE
SPOKANE WA, 99202-1334, US
Phone (509) 838-2531
Fax
Business Location
PO BOX 3649
SPOKANE WA, 99220-3649, US
Phone
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Washington
License Number PA10005143
Remove 1790835932 NPI Number
 

According to our database, Stacey Noel Boomer PA-C NPI is 1790835932, taxonomy code is 363A00000X and license number is PA10005143, license state is located at Washington. Stacey Noel Boomer PA-C physically located at 400 E 5th Ave, Spokane WA, 99202-1334. NPI Number Stacey Noel Boomer PA-C has the Individual type.

Sponsored links

1790835932 NPI number is provided on an as is basis without warranty of any kind. 1790835932 is maintained by the National Plan & Provider Enumeration System. The contents of Stacey Noel Boomer PA-C are for informational purposes only.