Individual
MS. MALINDA PAIGE WESTENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
465 MCKENNA DR, MOUNTAIN HOME, ID 83647-2143
(208) 587-9703
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8866
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2379
ID
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2022
Last updated
10/26/2022
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