Provider Demographics
NPI:1760112536
Name:BOATENG, FORSON ADDAE (RN-REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:FORSON
Middle Name:ADDAE
Last Name:BOATENG
Suffix:
Gender:M
Credentials:RN-REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5707 S AUGUSTA ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-2814
Mailing Address - Country:US
Mailing Address - Phone:206-898-1335
Mailing Address - Fax:206-413-5197
Practice Address - Street 1:5811 RAINIER AVE S STE 111
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2705
Practice Address - Country:US
Practice Address - Phone:206-898-1335
Practice Address - Fax:206-413-5197
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00162766163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health