Individual
JARED MUDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1551 E MULLAN AVE STE 200B, POST FALLS, ID 83854-9005
(208) 262-2213
(208) 262-2214
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2300
(208) 262-2390
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5761672
ID
Other
Enumeration date
11/21/2024
Last updated
01/22/2026
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