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NPI Code Detail

MEDICARE: SHIRLEY MURATA MSW

MEDICARE: SHIRLEY MURATA MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerL1475OR
21041C0700XClinical Social WorkerLCSW302ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LCSW302OTHERIDIDAHO LICENSE

General Provider Information

NPI Number : 1639108350
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIRLEY MURATA MSW
Provider Business Mailing Address
First Line : 1441 NE 10TH AVE
Second Line :
City : PAYETTE
State : ID
Zip : 83661-5420
Country : US
Telephone Number : 208-642-9376
Fax Number : 208-642-9598
Provider Business Practice Location Address
First Line : 1441 NE 10TH AVE
Second Line :
City : PAYETTE
State : ID
Zip : 83661-5420
Country : US
Telephone Number : 208-642-9376
Fax Number : 208-642-9598
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 07/08/2007

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Directions to “ SHIRLEY MURATA MSW” Practice Location

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