Boutry, Donald Alan
Boutry, Donald Alan is an individual health care provider with primary practice located at 314 Martin Luther King Jr Way Suite 104, Tacoma WA 98405-4250. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Boutry, Donald Alan can be contacted via phone (253) 403-5432.Contact Information
Primary practice address
314 Martin Luther King Jr Way Suite 104
Tacoma WA 98405-4250
Phone: (253) 403-5432
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | MD00025494 | Washington |
Profile Details
| NPI number | 1336134089 |
|---|---|
| LBN Legal business name | Boutry, Donald Alan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Jan 30th, 2012 - about 12 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 | 1336134089 | NPPES |
| Washington | MEDICAID | 7096845 |
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