Provider Demographics
NPI:1669659686
Name:BOULWARE, NATALIE J (NATUROPATH)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:J
Last Name:BOULWARE
Suffix:
Gender:F
Credentials:NATUROPATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-1547
Mailing Address - Country:US
Mailing Address - Phone:410-340-9001
Mailing Address - Fax:
Practice Address - Street 1:6223 TRAMORE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-1545
Practice Address - Country:US
Practice Address - Phone:410-340-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNAT1000816175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath