NPI age
19 years
Enumerated 2006-12-08
Across 1263 active physician assistant providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (WA) | 8406456 | |
| 01 | P00216067 | RAILROAD MCR |
| 01 (ID) | 1030537 | NCCPA |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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