NPI age
9 years
Enumerated 2016-11-03
Across 387 active physician assistant providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1245782416 | |
| 05 (OR) | 500762276 |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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