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Individual

DEAN A CHAPEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
6635 COMANCHE ST, BONNERS FERRY, ID 83805-7523
(208) 267-1718
(208) 267-7739
Mailing address
PO BOX 6228, HELENA, MT 59604-6228
(406) 457-4180

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-606
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010142695
REGENCE OF ID GROUP
ID
01
000010161379
REGENCE OF ID
ID
01
043634356
BRCHC TAX ID
ID
05
8065901
ID
01
8H104
BLUE CROSS OF ID GROUP
ID
01
PAF22
BLUE CROSS OF IDAHO
ID
Enumeration date
05/20/2006
Last updated
11/09/2015
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