Provider Demographics
NPI:1760261473
Name:BOCLAIR, MIRANDA JANELL (ND)
Entity Type:Individual
Prefix:DR
First Name:MIRANDA
Middle Name:JANELL
Last Name:BOCLAIR
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:MIRANDA
Other - Middle Name:JANELL
Other - Last Name:MAGALHAES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:7127 NE 167TH ST
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-6310
Mailing Address - Country:US
Mailing Address - Phone:315-854-0731
Mailing Address - Fax:
Practice Address - Street 1:14500 JUANITA DR NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-4966
Practice Address - Country:US
Practice Address - Phone:315-854-0731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty