Provider Demographics
NPI:1710756325
Name:FIELDING, JARED (PA)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:FIELDING
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Gender:M
Credentials:PA
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Mailing Address - Street 1:931 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-4775
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2315 8TH ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-7301
Practice Address - Country:US
Practice Address - Phone:208-298-3094
Practice Address - Fax:833-941-3874
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2024-08-29
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant