Individual
ANGELA HOFFMAN RADIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 W. FORT ST, # 111, BOISE, ID 83702
(208) 422-1000
(208) 422-1319
Mailing address
500 W. FORT ST, # 111, BOISE, ID 83702
(208) 422-1000
(208) 422-1319
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0102771
NY
363A00000X
Physician Assistant
PA01350
OR
363AM0700X
Medical Physician Assistant
Primary
PA736
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA01350
STATE OF OREGON
OR
01
—
PA736
STATE OF IDAHO
ID
Enumeration date
08/31/2006
Last updated
03/04/2022
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