# ST LUKES CLINIC-TREASURE VALLEY LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST LUKES HEALTH SYSTEM LTD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1326336058
- **Legal business name:** ST LUKES HEALTH SYSTEM LTD
- **Authorized official:** KATHRYN FOWLER (SENIOR VP, CFO)
- **Authorized official phone:** (208) 381-8717

## Contact information

- **Practice address:** 190 E BANNOCK ST, BOISE, ID 83712-6241
- **Practice address phone:** (208) 381-2222
- **Mailing address:** PO BOX 640, BOISE, ID 83701-0640
- **Mailing address phone:** (208) 381-2222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 03 | ID | — |
| 207Q00000X | Family Medicine Physician | 03 | ID | Yes |
| 207R00000X | Internal Medicine Physician | 03 | ID | — |
| 207RC0000X | Cardiovascular Disease Physician | 03 | ID | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 03 | ID | — |
| 207RH0003X | Hematology & Oncology Physician | 03 | ID | — |
| 207V00000X | Obstetrics & Gynecology Physician | 03 | ID | — |
| 207W00000X | Ophthalmology Physician | 03 | ID | — |
| 208000000X | Pediatrics Physician | 03 | ID | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | 03 | ID | — |
| 2080P0006X | Developmental - Behavioral Pediatrics Physician | 03 | ID | — |
| 2084N0400X | Neurology Physician | 03 | ID | — |
| 208600000X | Surgery Physician | 03 | ID | — |
| 208800000X | Urology Physician | 03 | ID | — |
| 208M00000X | Hospitalist Physician | 03 | ID | — |

## Other

- **Enumeration date:** 07/15/2011
- **Last updated:** 04/20/2026