Individual
DR. WAYNE MARCUS MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2094
(208) 381-1791
Mailing address
PO BOX 1108, CORVALLIS, OR 97339-1108
(208) 381-2094
(208) 381-1791
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M12065
ID
390200000X
Student in an Organized Health Care Education/Training Program
0116019824
VA
390200000X
Student in an Organized Health Care Education/Training Program
7152301-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
7152301-8905
UT
Other
Enumeration date
08/27/2007
Last updated
01/10/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us