Brandi Jo Boden, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP61187255 Issued in WA

Practice address

10004 204TH Ave E FL 3
Bonney Lake, WA 98391-6539

Phone

(253) 848-5951

NPI assigned

May 30, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Pacific NW Un of HS, Col of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Hill Family Medicine PCGroup PAC ID 8729980396, 67 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: bboden66949@direct.tecmc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Hill Family Medicine PC

  dba Sound Family Medicine

  • Family Medicine Physician
  • Puyallup, WA
  • NPI 1538253331
  Medicare reassignment Care Compare group NPD
• Multicare Health System

  dba MultiCare Good Samaritan Hospital

  • General Acute Care Hospital
  • Puyallup, WA
  • NPI 1841231461
  NPD (past)
• Sound Family Senior Clinic PLLC

  • Adult Medicine Physician
  • Puyallup, WA
  • NPI 1174116123
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1023676541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 4TH AVE NE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983727053",
            "telephone_number": "253-848-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 204TH AVE E FL 3",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916539",
            "telephone_number": "253-848-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODEN",
        "first_name": "BRANDI",
        "middle_name": "JO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61187255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2136024",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beyond Barriers Therapy PLLC
• Willie F Binion, PA-C
• Linda Lucile Bjork, CFM
• Summer Blake, LMT
• Bobby Virk DMD & Helena Skountrianos DDS, PLLC (Dentistry@ Bonney Lake)
• Agrini Boken, PA-C
• Michelle Bolland, MS
• Boncoeur Counseling Services LLC (BonCoeur Behavioral Health)
• Bonney Lake Chiropractic Inc, PS
• Bonney Lake Clinical Massage LLC

• Family Medicine Physician in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.