Individual
MADISON ASHLEY EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2434
(208) 799-5520
Mailing address
2290 WHITE AVE APT 304, MOSCOW, ID 83843-1050
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2481626
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2481626
IDAHO DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSES
ID
Enumeration date
08/05/2026
Last updated
08/05/2026
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