GARY L BOOG (NPI# 1710051255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710051255 |
| Entity Type | Individual |
| Full Name | GARY L BOOG |
| Other Name | GARY L BOOG |
| Credential | PA-C |
| Practice Address |
915 Anderson Dr Aberdeen WA 98520-1006 |
| Practice Telephone | 3605328830 |
| Mailing Telephone | 3605328830 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2016-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA60037894 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
915 ANDERSON DR |
| City | ABERDEEN |
| State | WA |
| Zip Code | 98520-1006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750334637 | Coastal Physician Anesthesia, Ps | Anesthesiology | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2006-05-19 |
| 1164048575 | Arashpreet Kaur Gill | Student in an Organized Health Care Education/Training Program | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2020-06-22 |
| 1295351716 | Norman Michael Snook | Student in an Organized Health Care Education/Training Program | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2020-06-20 |
| 1942825435 | Conner Martin Smith | Student in an Organized Health Care Education/Training Program | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2020-06-10 |
| 1508403197 | Michelle Eva Morholt | Nurse Practitioner | 915 Anderson Dr, Aberdeen, WA 98520-1097 | 2019-12-03 |
| 1801430350 | Maureen Ann Esget | Physical Therapy Assistant | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2019-10-28 |
| 1336798578 | John Harris | Student in an Organized Health Care Education/Training Program | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2019-09-10 |
| 1992354807 | Carter Thomas | Student in an Organized Health Care Education/Training Program | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2019-09-04 |
| 1467018275 | Ninoshka M Rivera Roldan | Student in an Organized Health Care Education/Training Program | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2019-05-16 |
| 1003472820 | Magdelene Kay May | Student in an Organized Health Care Education/Training Program | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2019-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740755354 | Wchs, Inc. | Clinic/Center | 516 East 1st Street, Aberdeen, WA 98520 | 2018-10-10 |
| 1518454180 | Katie Cutshaw | Counselor | 1700 Cherry Street, Suite C, Aberdeen, WA 98520 | 2018-04-18 |
| 1629587738 | Robert Williams | Counselor | Catholic Community Services, 403 West State Street, Suite 206, Aberdeen, WA 98520 | 2017-09-21 |
| 1174032296 | Amy D Tyler | Peer Specialist | 403 W State Street, Ste 206, Aberdeen, WA 98520 | 2017-09-20 |
| 1073032819 | Amanda Leona Franklin | Counselor | 2700 Simpson Ave, Suite 101, Aberdeen, WA 98520 | 2017-09-13 |
| 1184141152 | Chrystal Lynn Beckley | Counselor | 2700 Simpson Avenue Suite 101, Aberdeen, WA 98520 | 2017-08-29 |
| 1285158923 | Josh Butler | Technician/Technologist | 1718 Sumner Ave, Aberdeen, WA 98520 | 2017-08-02 |
| 1386165553 | Melvin Taylor | Counselor | 311 South I Street, Aberdeen, WA 98520 | 2017-06-28 |
| 1164870267 | Kelly Knittle | Counselor | 4820 She-nah-num Dr. Se, Olympia, WA 98520 | 2016-05-31 |
| 1437570249 | Aberdeen Therapy Works | Occupational Therapist | 100 S. I Street, Suite 205, Aberdeen, WA 98520 | 2013-12-20 |
| Find all providers in zip 98520 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013389683 | Amber Vasold | Physician Assistant | 16 Aberdeen Shopping Plz, Aberdeen, MD 21001-2247 | 2015-10-22 |
| 1679757884 | Jennifer Lee Kurman | Physician Assistant | 744 S Philadelphia Blvd Ste B, Aberdeen, MD 21001-3602 | 2007-12-24 |
| 1154396547 | Sarah Elizabeth Harr Jensen | Physician Assistant | 815 1st Ave Se Ste 104, Aberdeen, SD 57401-4602 | 2006-02-21 |
| 1508839499 | Nicholas Francis Wunder | Physician Assistant | 995 Hospitality Way, Aberdeen, MD 21001-1755 | 2006-02-10 |
| 1881012037 | Shaun Emory Smith | Physician Assistant | 915 Anderson Drive, Grays Harbor Community Hospital, Aberdeen, WA 98520 | 2014-04-04 |
| 1912334699 | Christopher Muldoon | Physician Assistant | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2013-09-26 |
| 1033543855 | Phyllis L. Barks | Physician Assistant | 1006 N H St Fl 4, Aberdeen, WA 98520-2521 | 2013-08-28 |
| 1205188786 | Brian Earl Goody | Physician Assistant | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2012-10-09 |
| 1174815088 | Avera St. Luke's | Physician Assistant | 615 6th Ave Se, Aberdeen, SD 57401 | 2011-05-11 |
| 1215240049 | Luciano Luis Figueroa | Physician Assistant | 191 Constantine Way, Aberdeen, WA 98520-9504 | 2010-07-21 |
| Find all providers in ABERDEEN | ||||
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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.