Provider Demographics
NPI:1336679042
Name:BOYDSTON, SUKI LP (RN)
Entity Type:Individual
Prefix:
First Name:SUKI
Middle Name:LP
Last Name:BOYDSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-0607
Mailing Address - Country:US
Mailing Address - Phone:360-378-4474
Mailing Address - Fax:360-378-7036
Practice Address - Street 1:145 RHONE ST
Practice Address - Street 2:
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-8070
Practice Address - Country:US
Practice Address - Phone:360-378-4474
Practice Address - Fax:360-378-7036
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00081186163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN00081186OtherRN LICENSE