Individual
BRET A PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
320 WARNER DR, LEWISTON, ID 83501-4441
(208) 743-3523
(208) 746-8741
Mailing address
320 WARNER DR, LEWISTON, ID 83501-4441
(208) 743-3523
(208) 746-8741
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA706
NV
363AS0400X
Surgical Physician Assistant
Primary
PA748
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679941553
—
ID
05
—
1679941553
—
WA
Enumeration date
10/19/2006
Last updated
06/24/2016
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