Provider Demographics
NPI:1437625662
Name:SATTERTHWAIT, ISABELLA M (PA-C)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:M
Last Name:SATTERTHWAIT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 E GOLDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1026
Mailing Address - Country:US
Mailing Address - Phone:208-367-5170
Mailing Address - Fax:
Practice Address - Street 1:3123 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-6972
Practice Address - Country:US
Practice Address - Phone:208-367-3131
Practice Address - Fax:208-367-4817
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDPA-1659363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant