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Search › Idaho › 2085R0202X

Wayne Mortensen, M.D

NPI 1780878314 · on the registry since 2007

Practice

Address
190 E Bannock St
Boise, ID 83712
Phone
(208) 381-2094
Fax
(208) 381-1791
Organisation at this address
St. Lukes
Picu Associates, Llc
St. Luke'S Children'S
St. Luke'S Health System
Boise Pathology Group P.A.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
694

Registry record

Primary taxonomy
2085R0202X
2085R0202X
Also registered as
390200000X
390200000X
390200000X
Licence states on file
VA, UT, ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-01-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho