NPI age
10 years
Enumerated 2015-06-19
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (WA) | 1629450218 | |
| 05 (ID) | 1629450218 |
Part of a multi-provider practice. 56 other active providers share this practice address in NPPES.
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