Boltz, Bailey N.
Boltz, Bailey N. is an individual health care provider with primary practice located at 3801 5Th St Se Ste 110 , Puyallup WA 98374-2106. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Boltz, Bailey N. can be contacted via phone (253) 845-9585.Contact Information
Primary practice address
3801 5Th St Se Ste 110
Puyallup WA 98374-2106
Phone: (253) 845-9585
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA61101539 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA61101539 | Washington |
Profile Details
| NPI number | 1831790591 |
|---|---|
| LBN Legal business name | Boltz, Bailey N. |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2020 |
| Last updated | Aug 18th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831790591 | NPPES |
| Washington | MEDICAID | 2171601 |
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