Individual
DARREN J KLASSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
223 16TH AVE N, NAMPA, ID 83687-4058
(208) 466-7869
(208) 466-5359
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 461-7149
(208) 467-3391
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA945
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1668986
MEDICARE IDAHO PTAN
ID
05
—
1861779829
—
ID
Enumeration date
11/04/2011
Last updated
12/27/2012
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