Individual
VICTORIA OZERAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1119 HIGHLAND AVE STE 11, CLARKSTON, WA 99403-2836
(509) 758-4450
Mailing address
PO BOX 189, CLARKSTON, WA 99403-0189
(208) 758-5511
(509) 758-3700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-409
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10142845
REGENCE OF ID URGENT CARE
ID
01
—
10142846
REGENCE OF IDAHO ER
ID
05
—
806533100
—
ID
05
—
8362154
—
WA
01
—
HBMZ5
BLUE CROSS OF IDAHO IND
ID
Enumeration date
02/02/2007
Last updated
08/20/2021
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