NPI age
19 years
Enumerated 2006-11-13
Across 1 active clinic/center providers in Idaho.
5 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010005483 | REGENCE |
| 01 (ID) | 8987-0 | BLUE CROSS OF IDAHO |
| 05 (WA) | 7025844 |
Multi-provider organization. 5 individual providers on file at this primary address.
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