Michael L Boucher, R PH
Individual provider Active NPI Pharmacist · Sequim, WA
NPI 1427348994 · NPPES record last updated Apr 18, 2011
Key facts
- NPI
- 1427348994
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH00009524 (WA)
- Practice address
- 520 W Washington St
Sequim, WA 98382-3279 - Phone
- (360) 681-0129
- Fax
- (360) 683-1431
- NPI assigned
- Apr 18, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00009524 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00009524 | WA | Yes |
Addresses
Primary practice location
520 W Washington St
Sequim, WA 98382-3279
Mailing address
520 W Washington St
Sequim, WA 98382-3279
Phone (360) 681-0129
Other names
- Mike Boucher
Other providers in Sequim, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.