NPI age
20 years
Enumerated 2005-09-30
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 | 601415700 | DEEIOC |
| 01 (ID) | S1303 | BLUE CROSS OF ID |
| 01 (WA) | 123363 | DEPT OF LABOR&INDUSTRIES |
| 05 (WA) | 8434839 | |
| 05 (ID) | 805169900 | |
| 01 (ID) | 000010004699 | REGENCE BS OF ID |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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