OrganizationActive
Boise Skin Clinic PLLC
NPI 1104220797 · Dermatology Physician · Boise, ID
Provider details
- NPI number
- 1104220797
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Marnie Ririe, Manager(208) 258-2078
- License
- M-9342 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1636 S Hadley Ave
Boise, ID 83709-2684
Phone: (208) 209-7898
Fax: (208) 258-2079
Approximate (ZIP-level) locationGet directions
Mailing address
1636 S Hadley Ave
Boise, ID 83709-2684
Registry dates
- Enumerated
- 2014-10-10
- Last updated
- 2019-01-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.