Individual
CLARKE B WEBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2400
(208) 262-2412
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2400
(208) 262-2412
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-108
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004394800
—
ID
Enumeration date
11/04/2005
Last updated
12/06/2010
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