KYLE DAVID LEROY BOOGAARD (NPI# 1689285348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689285348 |
| Entity Type | Individual |
| Full Name | KYLE DAVID LEROY BOOGAARD |
| Practice Address |
3033 Ingram St Hoquiam WA 98550-4410 |
| Practice Telephone | 3609640444 |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-08-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
3033 INGRAM ST |
| City | HOQUIAM |
| State | WA |
| Zip Code | 98550-4410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396251310 | Marla Dee Whalen | Counselor | 3033 Ingram St, Hoquiam, WA 98550-4410 | 2017-12-28 |
| 1164981734 | William Douglas Miles | Counselor | 3033 Ingram St, Hoquiam, WA 98550-4410 | 2019-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346709110 | Robin Sue Guyton | Peer Specialist | 615 8th St., Hoqwain, WA 98550 | 2019-03-19 |
| 1982183448 | Erica Gage Ekerson | Counselor | 244 E Wishkah, Aberdeen, VA 98550 | 2018-08-07 |
| 1245756618 | Harold Lockwood Moller I | Counselor | 205 8th Street, Hoquiam, WA 98550 | 2017-08-17 |
| 1063806719 | Kayla Fennell | Speech-Language Pathologist | 3035 Cherry Street, Hoquiam, WA 98550 | 2015-03-20 |
| 1003055831 | Cynthia Joy Taylor | Counselor | 615 8th Street, Hoquiam, WA 98550 | 2009-02-18 |
| 1689797813 | Hoquiam Chiropractic Inc Ps | Chiropractor | 2223 Simpson Ave, Hoquiam, WA 98550 | 2007-04-10 |
| 1679699128 | Assisted Living Concepts Inc | Assisted Living Facility | 1649 Broadway Avenue, Hoquiam, WA 98550 | 2007-03-22 |
| 1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
| 1396817391 | Somer Lee Osina | Massage Therapist | 320 23rd Street, Hoquiam, WA 98550 | 2006-11-14 |
| 1730266727 | Steven Rodney Earnest | Dentist | 2005 Sumner Ave, Hoquiam, WA 98550 | 2006-11-01 |
| Find all providers in zip 98550 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629612262 | Beth Peterson | Peer Specialist | 3033 Ingram St Ste 3033-b, Hoquiam, WA 98550-4410 | 2019-11-06 |
| 1821528720 | Aaron Paul Hamm | Peer Specialist | 205 8th St, Hoquiam, WA 98550-2507 | 2017-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992304703 | Corina Thornton | Peer Specialist | Arrow Lakes Street, Nespelem, WA 99155-0304 | 2020-10-22 |
| 1578161402 | Yavonnie Leslie Griggs | Peer Specialist | 3285 Ferguson Ln Sw, Tumwater, Wa 98512, Tumwater, WA 98512 | 2020-10-13 |
| 1306454061 | Ashley D Vinson-harris | Peer Specialist | 116 S 339th Cir, Federal Way, WA 98003-4537 | 2020-07-20 |
| 1184240301 | Aleric Hughes | Peer Specialist | 1200 Sw Holden St, Seattle, WA 98106-2054 | 2020-06-23 |
| 1013533876 | Alyssa Camille Meaker | Peer Specialist | 4350 Cordata Pkwy Ste 220, Bellingham, WA 98226-8278 | 2020-06-17 |
| 1134741424 | Tara Lin Garcia | Peer Specialist | 4256 Federal Avenue, Everett, WA 98203 | 2020-05-11 |
| 1558982058 | Edward Thomas Gollihugh | Peer Specialist | 721 Fawcett Ave Ste 204, Tacoma, WA 98402-5502 | 2020-05-06 |
| 1295356483 | Yvette Marie Sampson | Peer Specialist | Josephinum C/o Crew, 1902 2nd Ave., Seattle, WA 98101 | 2020-04-29 |
| 1043856123 | Jayde Wailani Albright | Peer Specialist | 5920 N Calispel St, Spokane, WA 99205-6214 | 2019-11-23 |
| 1033755244 | Willapa Behavioral Health | Peer Specialist | 2204 Pacific Ave. N., Long Beach, WA 98631 | 2019-11-22 |
| Find all providers with the same taxonomy | ||||
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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.