Lennis K Boyer, MD | |
1205 Se Professional Mall Blvd, Suite 104, Pullman, WA 99163-5423 | |
(509) 332-2605 | |
(509) 334-5754 |
Full Name | Lennis K Boyer |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 1205 Se Professional Mall Blvd, Pullman, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689657488 | NPI | - | NPPES |
8124323 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD0027662 (Washington) | Primary |
208000000X | Pediatrics | M5747 (Idaho) | Secondary |
Entity Name | Pullman Regional Hospital Clinic Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063646107 PECOS PAC ID: 4183753247 Enrollment ID: O20110111000936 |
Mailing Address | Practice Location Address |
---|---|
Lennis K Boyer, MD 1205 Se Professional Mall Blvd, Suite 104, Pullman, WA 99163-5423 Ph: (509) 332-2605 | Lennis K Boyer, MD 1205 Se Professional Mall Blvd, Suite 104, Pullman, WA 99163-5423 Ph: (509) 332-2605 |
Martha Hunt, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Ne 1125 Washington St, Washington State University, Pullman, WA 99164 Phone: 509-335-3575 | |
Joseph O Aiyenowo, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 825 Se Bishop Blvd Ste 200, Pullman, WA 99163 Phone: 509-332-2517 Fax: 509-334-9247 | |
Michael J Frostad, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1205 Se Professional Mall Blvd, Suite104, Pullman, WA 99163 Phone: 509-332-2605 Fax: 509-334-5754 | |
Jonathan Lee, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1205 Se Professional Mall Blvd Ste 104, Pullman, WA 99163 Phone: 509-332-2605 | |
Mackenzie Claire Rinaldi, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1205 Se Professional Mall Blvd Ste 104, Pullman, WA 99163 Phone: 509-332-2605 Fax: 509-715-2123 | |
Maricarmen Stout Shields, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1205 Se Professional Mall Blvd Ste 104, Pullman, WA 99163 Phone: 509-332-2605 Fax: 509-334-5754 |