Individual
PAUL HOWARD ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
98 POPLAR STREET, BLACKFOOT, ID 83221-1758
(208) 785-4100
(208) 785-3818
Mailing address
505 S 336TH ST, SUITE 336, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M-4622
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010140861
BSID
ID
05
—
003572600
—
ID
01
—
0194430
LIWA
WA
05
—
1026806
—
WA
05
—
1118485
—
ID
01
—
51672
BCID
ID
01
—
6059600 07
USDLAB
—
01
—
6499AL
BSWA
WA
01
—
8945381
VICTIMS OF CRIME
WA
05
—
Z2572
—
UT
Enumeration date
06/14/2006
Last updated
05/22/2008
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