Individual provider Active NPI

Bo Foulks

  • Licensed Practical Nurse
  • Seattle, WA
National Provider Identifier
1760647754
Registry record updated Jul 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP00046582 Issued in WA
Practice address
9809 34TH Ave SW
Seattle, WA 98126-4134
Phone
(206) 937-6402
NPI assigned
Jul 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP00046582 WA Primary

Addresses

Primary practice location

9809 34TH Ave SW
Seattle, WA 98126-4134

Mailing address

9809 34TH Ave SW
Seattle, WA 98126-4134
Phone (206) 937-6402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP00046582WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1216425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216425600000",
    "number": "1760647754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9809 34TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981264134",
            "telephone_number": "206-937-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9809 34TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981264134",
            "telephone_number": "206-937-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOULKS",
        "first_name": "BO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-19",
        "last_updated": "2008-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00046582",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 19, 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.