Candice Ketelsen, PA-C

NPI #1073040515 in Moscow, Idaho

Provider Information

NPI Number: 1073040515
Entity Type: Individual
Name: Candice Ketelsen, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: May 15, 2017
Last Updated: Jan 26, 2026

Practice Location

Address: 2500 W A ST STE 101
City: Moscow
State: Idaho
ZIP Code: 83843-6000
Phone: (208) 882-0540

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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