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Individual

NATHANIEL ASHBY VAN VALIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
750 N SYRINGA ST STE 100, POST FALLS, ID 83854-5275
(208) 262-2600
(208) 262-2700
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2498
(509) 381-3540

Taxonomy

Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
363AM0700X
Medical Physician Assistant
Primary
PA1482
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1386821759
ID
Enumeration date
01/28/2008
Last updated
03/30/2026
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