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Individual

ALISHA SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2065 E 17TH ST, IDAHO FALLS, ID 83404-8042
(800) 640-3451
(385) 287-1900
Mailing address
PO BOX 306, CHESTER, ID 83421-0306
(801) 572-3750
(801) 572-1097

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2219
ID
363A00000X
Physician Assistant
PA60424823
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
332584
STATE L&I
WA
Enumeration date
04/23/2014
Last updated
03/05/2024
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