Provider Demographics
NPI:1588269393
Name:BOLAND, MARGARET
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:BOLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S 50TH ST APT OFF-A
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-8399
Mailing Address - Country:US
Mailing Address - Phone:630-280-9058
Mailing Address - Fax:
Practice Address - Street 1:PUYALLUP SPECIAL SERVICES OFFICE
Practice Address - Street 2:214 W. MAIN
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-9837
Practice Address - Country:US
Practice Address - Phone:253-841-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist