NPI age
20 years
Enumerated 2006-05-25
Across 260 active surgery providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010002753 | REGENCE BLUE SHIELD OF ID |
| 01 (ID) | D0782 | BLUE CROSS OF IDAHO |
| 01 (WA) | 8909565 | WA CRIME VICTIMS PROGRAM |
| 05 (WA) | 1021856 | |
| 05 (ID) | 002599100 | |
| 01 (WA) | 0096144 | WA LABOR & INDUSTRY |
| 01 | 020006062 | RAILROAD MEDICARE |
| 01 (ID) | 82040040083501A003 | TRICARE/TRI WEST |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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