Bouchy, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1349 Issued in WA

Legal business name

BOUCHY, LLC

Practice address

805 Front St S
Issaquah, WA 98027-4205

Phone

(425) 392-1271

Fax

(425) 837-9682

NPI assigned

Jun 14, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Jackson, CPA

Title

Ceo, Administrator

Phone

(425) 392-1271

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Gardens At Issaquah Doing business as

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992700249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 FRONT ST S",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980274205",
            "telephone_number": "425-392-1271",
            "fax_number": "425-837-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 FRONT ST S",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980274205",
            "telephone_number": "425-392-1271",
            "fax_number": "425-837-9682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUCHY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO, ADMINISTRATOR",
        "authorized_official_telephone_number": "425-392-1271",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113494",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Gardens At Issaquah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ivana Elisa Borba Gomez, LAMFT
• Joseph Cheng Borin, DPT, MOTR/L
• Brenna Born, M.D.
• Anita Lynn Boser, LMP, CHP
• Mark Daniel Bouchard, MD
• Stephanie Ann Boutry, DPT
• Kelli Bowden
• Stephanie Anne Bowser, PSYD
• Luke Boyer, D.C.
• Thomas Boyer, DO

• Skilled Nursing Facility in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.