NPI age
19 years
Enumerated 2006-06-01
Across 1691 active family medicine providers in Idaho.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | 0344673 | LABOR AND INDUSTRIES |
| 05 (WA) | 2043374 | |
| 05 (WY) | 1199099-00 |
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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