Basic Information
| Provider Information | |||||||||
| NPI: | 1578741575 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOYSON | ||||||||
| FirstName: | GEORGINA | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4040 ORCHARD ST W STE 100 | ||||||||
| Address2: | |||||||||
| City: | FIRCREST | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984666610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535641560 | ||||||||
| FaxNumber: | 2535644449 | ||||||||
| Practice Location | |||||||||
| Address1: | 4040 ORCHARD ST W STE 100 | ||||||||
| Address2: | |||||||||
| City: | FIRCREST | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984666610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535641560 | ||||||||
| FaxNumber: | 2535644449 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2008 | ||||||||
| LastUpdateDate: | 12/16/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/16/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT00000812 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.