# TODD A OSTLIE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1063481620
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10004002 | WA | Yes |

## Other

- **Enumeration date:** 03/16/2006
- **Last updated:** 12/06/2024

## 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 |