NPI 1104220797

Boise Skin Clinic PLLC

Organisation Dermatology Physician Boise, ID

Practice location

Address: 1636 S Hadley Ave, Boise, ID 83709-2684
Phone: (208) 209-7898
Fax: (208) 258-2079

Authorised official

Name: Marnie R Ririe
Title: Manager
Phone: (208) 258-2078

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence M-9342 (ID)

Other Dermatology providers in Idaho →

Registry record

NPI: 1104220797
Entity type: Organization
NPI issued: 10 Oct 2014
Record last updated: 22 Jan 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.