NPI age
20 years
Enumerated 2005-05-31
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | 0265455 | LABOR & INDUSTRIES |
| 01 (ID) | 1063415404 | REGENCE BLUESHIELD |
| 05 (ID) | 1063415404 | |
| 05 (WA) | 2009649 | |
| 01 (ID) | P00884048 | RR MEDICARE |
| 01 (ID) | 78399 | BC/ID |
Part of a multi-provider practice. 56 other active providers share this practice address in NPPES.
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