NPI age
19 years
Enumerated 2007-04-03
Across 16 active clinic/center providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (WA) | 042414 | |
| 05 (ID) | 8054618 | |
| 05 (ID) | 002790202 | |
| 05 (ID) | 0027901 | |
| 01 (WA) | 129765 | WASSH. L & I |
| 05 (WA) | 9043217 | |
| 05 (ID) | 0027902 | |
| 05 (ID) | 0027903 | |
| 05 (ID) | 8063364 | |
| 05 (ID) | 8069168 | |
| 05 (ID) | 8072218 | |
| 05 (ID) | 8050088 | |
| 05 (ID) | 8043067 |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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