DR. HENRY M BOUDIN (NPI# 1104916469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104916469 |
| Entity Type | Individual |
| Full Name | DR. HENRY M BOUDIN |
| Credential | PHD |
| Practice Address |
3900 E Valley Rd Suite 100 Renton WA 98055-4954 |
| Practice Telephone | 4252510698 |
| Practice Fax Number | 4252518974 |
| Mailing Telephone | 4252510698 |
| Mailing Fax Number | 4252518974 |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1001 | WA | Behavioral Health & Social Service Providers |
| Street Address |
3900 E VALLEY RD SUITE 100 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-4954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467574855 | Adultcare of Renton | Clinic/Center | 3900 E Valley Rd, Ste 101, Renton, WA 98055-4954 | 2007-04-04 |
| 1932299294 | Mary Anne Boudin | Psychologist | 3900 E Valley Rd, Suite 100, Renton, WA 98057-4954 | 2006-10-14 |
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|---|---|---|---|---|
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| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457530891 | Jennifer Sachek | Psychologist | 600 Oakesdale Ave Sw Ste 104, Renton, WA 98057-5226 | 2007-11-02 |
| 1093892549 | Richard Jeffrey Palmer | Psychologist | 3900 E Valley Rd Ste 100, Renton, WA 98055-4954 | 2006-11-01 |
| 1922112937 | Diane M Adams | Psychologist | 1412 Sw 43rd St Ste 240, Renton, WA 98057-4803 | 2006-08-18 |
| 1700898350 | Lizabeth Vila | Psychologist | 9806 Se Carr Rd, Renton, WA 98055-5813 | 2006-08-12 |
| 1225352263 | Trina Tobey Eide | Psychologist | 600 Oakesdale Ave Sw Ste 104, Renton, WA 98057-5226 | 2010-03-19 |
| 1891934105 | Benjamin Erskine Johnson | Psychologist | 304 Main Ave S, Ste 303, Renton, WA 98057-2758 | 2009-02-10 |
| 1417138579 | Cathi A Korth | Psychologist | 600 Oakesdale Ave Sw, Suite #104, Renton, WA 98057 | 2007-11-16 |
| 1932299294 | Mary Anne Boudin | Psychologist | 3900 E Valley Rd, Suite 100, Renton, WA 98057-4954 | 2006-10-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.