Individual
SASHA MUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
300 S 23RD ST, BOISE, ID 83702-9100
(208) 344-3512
(208) 466-5359
Mailing address
PO BOX 9, NAMPA, ID 83653-0009
(208) 467-4431
(208) 466-5359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1851
ID
Other
Enumeration date
02/23/2016
Last updated
11/15/2022
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