Individual
DANIELLE BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 746-6348
Mailing address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 746-6348
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1210
ID
363A00000X
Physician Assistant
PA60494489
WA
363AS0400X
Surgical Physician Assistant
PA60494489
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356747042
—
ID
05
—
1356747042
—
WA
Enumeration date
11/07/2014
Last updated
02/16/2017
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