MICHAEL BOLDUC (NPI# 1548786080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548786080 |
| Entity Type | Individual |
| Full Name | MICHAEL BOLDUC |
| Practice Address |
Madigan Army Medical Center 9040 Jackson Ave Tacoma WA 98431-4501 |
| Mailing Address |
Bamc 3851 Roger Brooke Drive, Mcheqd (creds) Fort Sam Houston TX 78234-6200 |
| Practice Telephone | 9105473017 |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2020-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396740254 | Dennis Huang | Podiatrist | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2005-06-16 |
| 1891395851 | Juliana Dumayas | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0002 | 2020-10-29 |
| 1922658491 | Fatima Hossay Safi | Social Worker | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-09-17 |
| 1134778095 | Vinzuella Boddie | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-09-04 |
| 1588219059 | Susan Marie Lopez | Dietitian, Registered | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-08-01 |
| 1174177109 | Bradley Scott Miller | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2019-07-29 |
| 1437703568 | Alex Alberto Hernandez Vargas | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-07-26 |
| 1427619733 | Dana Michelle Sanchez-terry | Nurse Practitioner | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431 | 2019-06-26 |
| 1255998076 | Scott Michael Brown | Military Health Care Provider | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-5650 | 2019-05-28 |
| 1861059081 | Nathaniel Alan Castonguay | Licensed Practical Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2019-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295244887 | Gregory Lloyd | Physical Therapist | 1407 E 72nd St Ste A100, Tacoma, WA 98404-5906 | 2017-09-26 |
| 1477746857 | William Joseph Russell Jr. | Physical Therapist | 12001 Pacific Ave S Ste 101, Tacoma, WA 98444-5101 | 2007-08-20 |
| 1699808113 | Paul Drumheller | Physical Therapist | 1 N Tacoma Ave, Ste 103, Tacoma, WA 98403-3131 | 2007-03-13 |
| 1750349106 | Lisa Marie O'block | Physical Therapist | Madigan Army Medical Center 9040jackson Ave, Tacoma, WA 98431-0001 | 2006-05-03 |
| 1326027020 | Parkland Physical Therapy, Pllc | Physical Therapist | 12001 Pacific Ave S, Tacoma, WA 98444-5101 | 2006-01-11 |
| 1639176431 | Daniel James Gage | Physical Therapist | Physical Therapy Department,madigan Army Medical Center, Fort Lewis Washington, Tacoma, WA 98421 | 2005-07-07 |
| 1396356424 | Denali Leeona Pavlich-wheeler | Physical Therapist | 1 N Tacoma Ave Ste 103, Tacoma, WA 98403-3131 | 2020-08-12 |
| 1639797467 | Christopher Dailey | Physical Therapist | 1901 S Cedar St Ste B1, Tacoma, WA 98405-2305 | 2020-07-08 |
| 1871137570 | Richard Simmet | Physical Therapist | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-11-05 |
| 1306346499 | Zachary Rynders | Physical Therapist | 1 N Tacoma Ave, Tacoma, WA 98403-3131 | 2018-02-15 |
| Find all providers in TACOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.