Individual
MS. LAURA MARIE GIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
Mailing address
415 6TH STREET, EMERGENCY DEPARTMENT, LEWISTON, ID 83501-2431
(208) 799-5457
(208) 799-5766
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1434
ID
363A00000X
Physician Assistant
PA61022472
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2074831
—
WA
Enumeration date
09/14/2015
Last updated
09/12/2025
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