Individual
CLYDE ARTHUR HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
622 W COLLEGE AVE STE 2, ST MARIES, ID 83861-1822
(208) 568-7800
(877) 902-7131
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2498
(208) 262-7461
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
O-231
ID
207P00000X
Emergency Medicine Physician
OP60768791
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010028719
REGENCE BS IDAHO
ID
01
—
141315
WA LABOR & INDUSTRIES
WA
01
—
601415900
DEEIOC
—
05
—
805770200
—
ID
05
—
8434847
—
WA
01
—
S3168
BC OF ID
ID
Enumeration date
12/04/2006
Last updated
02/19/2026
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