Bouma Orthosport, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BOUMA ORTHOSPORT, LLC

Practice address

4037 46TH Ave SW
Seattle, WA 98116-3725

Phone

(206) 200-2495

NPI assigned

May 19, 2020

Last updated

May 21, 2020By 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

Mark Jeffrey Bouma, DPTNPI 1659381069

Title

Owner

Phone

(206) 200-2495

Specialties & licenses 1

Addresses

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.

• Mark J Bouma, DPT

  • Physical Therapist
  • Mercer Island, WA
  • NPI 1659381069
  NPD Authorized official

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1740803246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4037 46TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981163725",
            "telephone_number": "206-200-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4037 46TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981163725",
            "telephone_number": "206-200-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUMA ORTHOSPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "BOUMA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-200-2495",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony A Bouldin, MD
• Amanda E Boulis, PA
• Sara Boulos, RPH
• Caitlin Elise Boulware, MSOT
• Gusty-Lee Boulware, PHD-BCBA-D
• Laura Louise Spiers Bouma, DPT
• Stefanie Bouma, PA
• Seth Boun
• Lori Bourassa, PHD
• Michael David Bourbonnais, D.C.

• Physical Therapy Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Therapy Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.