Individual
SHARENE E WATSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
403 SOUTH 11TH ST, STE 100, BOISE, ID 83702-6906
(208) 429-0300
(208) 429-0305
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA579
ID
Other
Enumeration date
07/06/2006
Last updated
09/06/2013
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