Provider Demographics
NPI:1154519049
Name:BOONE, KAREN (OMD, PHD, LAC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BOONE
Suffix:
Gender:F
Credentials:OMD, PHD, LAC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:BOONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:848 N RAINBOW BLVD # 843
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-1103
Mailing Address - Country:US
Mailing Address - Phone:206-888-2042
Mailing Address - Fax:206-350-8665
Practice Address - Street 1:3960 HOWARD HUGHES PKWY STE 500
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-5988
Practice Address - Country:US
Practice Address - Phone:206-888-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2672171100000X
CO441171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist