NPI age
20 years
Enumerated 2005-10-28
Across 598 active optometrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | KLEDA5047950479 | PREMERA |
| 01 (ID) | 000010015581 | REGENCE |
| 05 (ID) | 000309000 | |
| 01 (ID) | V7167 | BLUE CROSS OF IDAHO |
| 05 (WA) | 2022739 | |
| 01 (ID) | 0133176 | DEPT OF LABOR & INDUSTRY |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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