NPI age
18 years
Enumerated 2007-06-14
Across 1691 active family medicine providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1831393461 | |
| 01 (ID) | 1831393461 | REGENCE BLUE SHIELD |
| 01 (WA) | 258489 | WA LABOR & INDUSTRIES |
| 01 (ID) | 78191 | BC/ID |
| 05 (WA) | 2004664 | |
| 01 (ID) | P00843956 | MEDICARE RR |
Solo or small practice. No other active providers share this practice address in NPPES.
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