Shanda J Boardman

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

400 E 33Rd St
Vancouver, WA 98663-2238

Phone

(360) 696-2561

NPI assigned

May 28, 2008

Last updated

May 28, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1073771879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W MCLOUGHLIN BLVD APT 4",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602564",
            "telephone_number": "360-696-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 33RD ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632238",
            "telephone_number": "360-696-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARDMAN",
        "first_name": "SHANDA",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.