Individual
TAIYLER JADE SODERQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, NREMT
Contact information
Practice address
875 PERIMETER DR, MOSCOW, ID 83844-9803
(208) 885-6111
Mailing address
7628 N APPOMATTOX CT, SPOKANE, WA 99208-5667
(509) 789-0027
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
—
—
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/16/2023
Last updated
06/09/2025
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