Individual
YVONNE L ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2448 N MERRIT CREEK LOOP, SUITE 2A, COEUR D ALENE, ID 83814-4953
(208) 664-2901
(208) 667-9266
Mailing address
2448 N MERRIT CREEK LOOP, SUITE 2A, COEUR D ALENE, ID 83814-4953
(208) 664-2901
(208) 667-9266
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT 2213
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010175553
BLUE SHIELD
ID
01
—
185598800
FEDERAL L&I
—
01
—
262004
WA L&I
—
01
—
32101
GROUP HEALTH
—
01
—
4746230001
MEDICARE-DME
ID
01
—
5003984
REGENCE MEDADVANTAGE
—
01
—
82-0534955
STATE INS FUND
—
01
—
82053495583814A009
TRIWEST/TRICARE
—
01
—
88753
FIRST CHOICE
—
05
—
907605881
—
ID
01
—
DA3588
RAIL ROAD MEDICARE
—
01
—
QMXPR0060660
MOLINA
—
01
—
TD895
BLUE CROSS
ID
Enumeration date
06/18/2007
Last updated
09/16/2010
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