| Brett Johansen, PA-C | |
|
1210 Nw 16th St, Fruitland, ID 83619-2202 | |
| (208) 452-9881 | |
| Not Available |
| Full Name | Brett Johansen |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 9 Years |
| Location | 1210 Nw 16th St, Fruitland, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982074696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA-1308 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Nampa Medical Center | Nampa, ID | Hospital |
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Lukes Clinic-treasure Valley Llc | 4981878402 | 991 |
| Mailing Address | Practice Location Address |
|---|---|
| Brett Johansen, PA-C 1210 Nw 16th St, Fruitland, ID 83619-2202 Ph: (208) 452-9881 | Brett Johansen, PA-C 1210 Nw 16th St, Fruitland, ID 83619-2202 Ph: (208) 452-9881 |
Tea Hasanovic, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2101 N Whitley Dr, Fruitland, ID 83619 Phone: 208-452-5999 | |
George J Roth, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1210 Nw 16th St, Fruitland, ID 83619 Phone: 208-452-8600 Fax: 208-452-8601 | |
Charles Edward Brioschi Jr., PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 910 Nw 16th Street, Ste 205, Fruitland, ID 83619 Phone: 208-452-3111 Fax: 208-452-3666 | |
Jaclyn R Hope, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1210 Nw 16th St, Fruitland, ID 83619 Phone: 208-452-8600 | |
Thad W Wilkey, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2101 N Whitley Dr, Fruitland, ID 83619 Phone: 208-452-5999 Fax: 208-452-4499 | |
Mrs. Crysta Kimes, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 910 Nw 16th St Ste 101, Fruitland, ID 83619 Phone: 208-452-8000 | |
Victor M Ishida, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 910 Nw 16th St Ste 101, Fruitland, ID 83619 Phone: 208-452-8050 Fax: 208-452-8055 |