NPI age
20 years
Enumerated 2006-04-20
Across 1263 active physician assistant providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807116700 | |
| 05 (WA) | 8421174 | |
| 01 | 16666921 | MEDICARE PTAN |
| 05 (WA) | 7144785 | |
| 05 (ID) | 8080036 | |
| 01 | 1370136 | MEDICARE GROUP PTAN |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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