Provider Demographics
NPI:1457115404
Name:BOYCE, KJIRSTE (LMT)
Entity Type:Individual
Prefix:
First Name:KJIRSTE
Middle Name:
Last Name:BOYCE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17917 107TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-5104
Mailing Address - Country:US
Mailing Address - Phone:808-442-2545
Mailing Address - Fax:
Practice Address - Street 1:17917 VASHON HWY SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-5204
Practice Address - Country:US
Practice Address - Phone:808-442-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA000163952278P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No2278P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Rehabilitation