Provider Demographics
NPI:1801353719
Name:BOYD COWAN, LLC
Entity type:Organization
Organization Name:BOYD COWAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, PMHNP-BC
Authorized Official - Phone:206-599-9991
Mailing Address - Street 1:220 ROBERTS RD SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4657
Mailing Address - Country:US
Mailing Address - Phone:206-599-9991
Mailing Address - Fax:360-252-6091
Practice Address - Street 1:209 4TH AVE E STE 214
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-6969
Practice Address - Country:US
Practice Address - Phone:206-599-9991
Practice Address - Fax:360-252-6091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty