Individual
DANIELLE MARIE WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
619 S WASHINGTON ST, STE 202, MOSCOW, ID 83843-3090
(208) 882-8534
Mailing address
619 S WASHINGTON ST, STE 202, MOSCOW, ID 83843-3090
(208) 882-8534
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MAS-161
ID
Other
Enumeration date
06/19/2013
Last updated
09/17/2015
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