NPI age
19 years
Enumerated 2006-08-31
Across 387 active physician assistant providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | PA736 | STATE OF IDAHO |
| 01 (OR) | PA01350 | STATE OF OREGON |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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