Individual
NATHANIEL SCOTT THORESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1132 E POLSTON AVE, POST FALLS, ID 83854-6045
(208) 777-7800
(208) 777-9209
Mailing address
1132 E POLSTON AVE, POST FALLS, ID 83854-6045
(208) 777-7800
(208) 777-9209
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT1354
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010025022
REGENCE BLUE SHIELD
ID
01
—
126619
WASHINGTON L&I
WA
01
—
14490
GROUP HEALTH
ID
01
—
P00155553
RAILROAD MEDICARE
ID
01
—
T3548
BLUE CROSS
ID
Enumeration date
10/17/2006
Last updated
07/08/2007
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