Individual
ECHO T VANDERWAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
420 N 2ND AVE, STE 100, SANDPOINT, ID 83864-1565
(208) 265-2242
(208) 265-8214
Mailing address
420 N 2ND AVE, STE 100, SANDPOINT, ID 83864-1565
(208) 265-2242
(208) 265-8214
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA671
ID
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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