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Individual

DR. ROGER CLAUS EHLERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
424 E SHERMAN AVE, SUITE 107, COEUR D ALENE, ID 83814-1701
(208) 667-0544
(208) 667-0544
Mailing address
424 E SHERMAN AVE, SUITE 107, COEUR D ALENE, ID 83814-1701
(208) 667-0544
(208) 667-0544

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY56
ID
103T00000X
Psychologist
PY00000622
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010015973
REGENCE BLUE SHIELD OF ID
ID
01
N0567
BLUE CROSS OF IDAHO
ID
01
N4700
BLUE CROSS OF IDAHO
ID
Enumeration date
10/05/2006
Last updated
07/10/2008
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