Provider Demographics
NPI:1760835722
Name:BOERS-GEIN, LUC FLOYD GERARD (CNA)
Entity Type:Individual
Prefix:MR
First Name:LUC
Middle Name:FLOYD GERARD
Last Name:BOERS-GEIN
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22315 50TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-6053
Mailing Address - Country:US
Mailing Address - Phone:253-380-5049
Mailing Address - Fax:253-380-5049
Practice Address - Street 1:22315 50TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-6053
Practice Address - Country:US
Practice Address - Phone:253-380-5049
Practice Address - Fax:253-380-5049
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANA60639163376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide