| NPI | 1801114129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA A DURKIN Credentialling Manager 208-664-4026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10003131) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA6011816) |
| 363L00000X Nurse Practitioner (Licence: WA AP30003426) | |
| 363L00000X Nurse Practitioner (Licence: WA Ap30007150) | |
| 363L00000X Nurse Practitioner (Licence: WA Ap30006427) | |
| 363L00000X Nurse Practitioner (Licence: WA AP30007497) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-05-11 |