NPI age
20 years
Enumerated 2005-12-30
Across 23 active radiology providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1023096955 | |
| 01 (WA) | 178136 | L&I PROVIDER NUMBER |
| 05 (WA) | 8372898 | |
| 01 (WA) | 175410 | L&I PROVIDER NUMBER |
Part of a multi-provider practice. 119 other active providers share this practice address in NPPES.
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