Michael Boltwood , Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY00001641 Issued in WA

Legal business name

MICHAEL BOLTWOOD , INC

Practice address

6000 Whale Dancer CT NE
Suquamish, WA 98392-9648

Phone

(360) 698-1321

Fax

(360) 308-0447

NPI assigned

Dec 13, 2007

Last updated

Dec 30, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Boltwood, PHDNPI 1487739694

Title

Owner

Phone

(360) 698-1321

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Boltwood, PHD

  • Psychologist
  • Suquamish, WA
  • NPI 1487739694
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1427231307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2324",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983832324",
            "telephone_number": "360-698-1321",
            "fax_number": "360-308-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 WHALE DANCER CT NE",
            "city": "SUQUAMISH",
            "state": "WA",
            "postal_code": "983929648",
            "telephone_number": "360-698-1321",
            "fax_number": "360-308-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL BOLTWOOD , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A",
        "authorized_official_last_name": "BOLTWOOD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-698-1321",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00001641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7069149",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Kernan, DO
• Alexander C Kraft, ND, LAC
• Magdalena Lavecchia, C061117076 SUDPT
• Patricia Riley Lindsay, LMP
• Dolores McConaghy, CDP
• Frances Galasyn Miller, MPH, RDN
• Martha Jo Mitchell-Colby
• Joseph Montalbo, CDP
• Elizabeth Marie Napoleon, CO
• Robin Lee Nielsen, CDP

• Psychologist in Suquamish, WA
• Providers in Suquamish, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.