Provider Demographics
NPI:1366977803
Name:BOYD, TARA LEANN (ND)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:LEANN
Last Name:BOYD
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19916 OLD OWEN RD STE 766
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-9778
Mailing Address - Country:US
Mailing Address - Phone:425-365-3311
Mailing Address - Fax:
Practice Address - Street 1:1200 116TH AVE NE STE C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3802
Practice Address - Country:US
Practice Address - Phone:425-451-0404
Practice Address - Fax:425-462-8919
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60752536175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath