Individual
JOSHUA JON BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1352
(208) 367-6416
Mailing address
PO BOX 4008, PORTLAND, OR 97208-4008
(503) 372-2740
(503) 372-2754
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N34868
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA655
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010672601002
BCBSOK
OK
Enumeration date
06/01/2006
Last updated
11/20/2007
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