| NPI | 1790816262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN COLBURN Director Of Business Services 208-799-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| 207RH0003X Internal Medicine Hematology & Oncology | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-11-05 |