Individual
AMY S EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1636 S LAKE CREST WAY, EAGLE, ID 83616-7142
(208) 939-9131
(208) 345-1890
Mailing address
1636 S LAKE CREST WAY, EAGLE, ID 83616-7142
(208) 939-9131
(208) 345-1890
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M-11410
ID
2084P0800X
Psychiatry Physician
MD00048140
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8484347
—
WA
Enumeration date
09/06/2005
Last updated
03/07/2024
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