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Individual

TARA ASHLEY DOROSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
850 W IRONWOOD DR STE 301, COEUR D ALENE, ID 83814-4903
(208) 667-9762
Mailing address
3207 E BERVEN BAY CT, HAYDEN LAKE, ID 83835-9005
(208) 420-5606

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1607
ID

Other

Enumeration date
04/11/2018
Last updated
09/10/2024
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