NPI age
18 years
Enumerated 2007-12-24
Across 36 active clinic/center providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 8N389 | BLUE CROSS OF IDAHO |
| 05 (WA) | 8239220 | |
| 01 (ID) | 000010166370 | REGENCE BLUE SHIELD |
| 05 (ID) | 808003600 |
Multi-provider organization. 1 individual provider on file at this primary address.
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