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Individual
TODD A OSTLIE
Active
Individual
TODD A OSTLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004002
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010139032
REGENCE BLUE SHIELD OF ID
ID
01
—
152849
DEPT OF LABOR & INDUSTRIE
WA
01
—
19618
GROUP HEALTH NW
WA
01
—
379109600
OWCP
WA
01
—
5035OS
ASURIS NW HEALTH
WA
05
—
8387326
—
WA
01
—
970027251
RR MEDICARE
WA
01
—
K6443
BLUE CROSS OF IDAHO
ID
Enumeration date
03/16/2006
Last updated
12/06/2024
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