Ethan Andrew Davenport
Ethan Andrew Davenport is a Community Health Worker in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2026.
- Licensed in
- ID
- In the registry since
- 2026
Practice location Address checks out
2265 W Broadway StIdaho Falls, ID 83402-2996
Phone: (208) 524-7400
Fax: (208) 524-8004
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community Health Worker (primary) | Taxonomy 172V00000X (ID) |
|---|
Record details
| NPI number | 1912811936 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | September 29, 2026 |
| Last updated in NPPES | September 29, 2026 |
| Certification date | September 29, 2026 |
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Carrie Bronson
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Samuel Jacob Christiansen, BS
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Ashley Clement
2265 W Broadway St, Idaho Falls, ID 83402-2996 · (208) 524-7400
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Jordan Davis
2265 W Broadway St, Idaho Falls, ID 83402-2996 · (208) 524-7400
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Tysen Derek Davis
2265 W Broadway St, Idaho Falls, ID 83402-2996 · (208) 524-7400
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Nicole De Jong
2265 W Broadway St, Idaho Falls, ID 83402-2996 · (208) 524-7400
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Kira Dedic
2265 W Broadway St, Idaho Falls, ID 83402-2996 · (208) 524-7400