NPI age
19 years
Enumerated 2007-03-02
Across 1263 active physician assistant providers in Idaho.
4 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | 0221381 | LABOR & IND. |
| 05 (WA) | 8483737 | |
| 01 (WA) | 8944544 | CRIME VICTIMS |
Part of a multi-provider practice. 21 other active providers share this practice address in NPPES.
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