Jefferson L Boulet, PAC is a medicare enrolled "Physician Assistant - Medical" in Buckley, Washington. He graduated from nursing school in 1997 and has 27 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice White River Family Care Llc and his current practice location is
305 N River Ave, Buckley, Washington. You can reach out to his office (for appointments etc.) via phone at
(360) 829-0625.
Jefferson L Boulet is licensed to practice in Washington (license number PA10003567) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1740274745.
Provider's Profile
| Full Name | Jefferson L Boulet |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 27 Years |
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| Location | 305 N River Ave, Buckley, Washington |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jefferson L Boulet graduated from nursing school in 1997
NPI Data:
- NPI Number: 1740274745
- Provider Enumeration Date: 09/06/2005
- Last Update Date: 03/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 4688700974
- Enrollment ID: I20100325000615
Medical Identifiers
Medical identifiers for Jefferson L Boulet such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740274745 | NPI | - | NPPES |
| 8542300 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363AM0700X | Physician Assistant - Medical | PA10003567 (Washington) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| White River Family Care Llc | 1254323447 | 3 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jefferson L Boulet is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jefferson L Boulet, PAC
Po Box 1268,
Buckley, WA 98321-1268
Ph: (360) 829-0625 | Jefferson L Boulet, PAC
305 N River Ave,
Buckley, WA 98321-8978
Ph: (360) 829-0625 |
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