Individual provider Active NPI

Stephen Lawrence Boulanger, RPH.

  • Pharmacist
  • Mountlake Terrace, WA
National Provider Identifier
1902847296
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00013587 Issued in WA
Practice address
22316 70TH Ave W Ste 5
Mountlake Terrace, WA 98043-2184
Phone
(425) 673-5200
Fax
(425) 673-5230
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00013587 WA Primary

Addresses

Primary practice location

22316 70TH Ave W Ste 5
Mountlake Terrace, WA 98043-2184

Mailing address

20232 21St Ave NW
Shoreline, WA 98177-2314

Other names 1

  • Steve L Boulanger Other name

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH00013587WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercury Pharmacy Services Inc CurrentSince Feb 23, 2025 Accepting new patients
Guardian Pharmacy of Washington, LLC Current Accepting new patients
MPS Clinical Services LLC CurrentSince Feb 23, 2025 Accepting new patients

Locations

22316 70th Ave W
Ste 5
Mountlake Terrace, WA 98043
Phone (425) 673-5200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1902847296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20232 21ST AVE NW",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981772314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22316 70TH AVE W STE 5",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432184",
            "telephone_number": "425-673-5200",
            "fax_number": "425-673-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULANGER",
        "first_name": "STEPHEN",
        "middle_name": "LAWRENCE",
        "credential": "RPH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00013587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEVE",
            "last_name": "BOULANGER",
            "middle_name": "L",
            "credential": "RPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.