Individual
THEODORE K KRISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
208000000X
Pediatrics Physician
Primary
M3676
ID
208000000X
Pediatrics Physician
MD00040584
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0171659
WA LABOR & INDUSTRIES
WA
05
—
1089838
—
WA
01
—
1396828158
REGENCE BLUESHIELD
ID
05
—
1396828158
—
ID
01
—
DF508
BLUE CROSS
ID
Enumeration date
10/23/2006
Last updated
03/08/2016
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