Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jefferson L Boulet, PAC

Individual provider Medical Physician Assistant · NPI 1740274745

Jefferson L Boulet, PAC is a Physician Assistant in Buckley, Washington. Qualified in 1997, 29 years ago. Practices with White River Family Care LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
29
Licensed in
WA
In the registry since
2005
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Practice location Address checks out

305 N River Ave
Buckley, WA 98321-8978
Phone: (360) 829-0625
Fax: (360) 829-9860
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA10003567 (WA)

Record details

NPI number1740274745
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedSeptember 6, 2005
Last updated in NPPESMarch 7, 2023
Mailing addressPo Box 1268, Buckley, WA 98321-1268

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice White River Family Care Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount