Organization Active NPI

Guy R. Boswell,O.D. LLC

  • Optometrist
  • Seattle, WA
National Provider Identifier
1376816793
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD 502 Issued in WA
Legal business name
GUY R. BOSWELL,O.D. LLC
Practice address
3114 NE 125TH St
Seattle, WA 98125-4515
Phone
(206) 363-9111
NPI assigned
Feb 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Authorized official

Name
Guy R. Boswell, O.D
Title
Owner
Phone
(206) 363-9111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD 502 WA Primary

Addresses

Primary practice location

3114 NE 125TH St
Seattle, WA 98125-4515

Mailing address

3114 NE 125TH St
Seattle, WA 98125-4515
Phone (206) 363-9111

Other identifiers 1

IdentifierTypeStateIssuer
2007879MedicaidWA

National Provider Directory

National Provider Directory

Locations

3114 NE 125th St
Seattle, WA 98125
Phone (206) 363-9111

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1376816793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 NE 125TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254515",
            "telephone_number": "206-363-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 NE 125TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254515",
            "telephone_number": "206-363-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUY R. BOSWELL,O.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "BOSWELL",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-363-9111",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2007879",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.