Individual
MR. CHARLES JASON ANSTRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4400 E FLAMINGO AVE, NAMPA, ID 83687-9203
(208) 367-6099
(208) 367-6085
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-980
ID
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
08/19/2006
Last updated
11/28/2012
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