# CHILDRENS KIDNEY SPECIALISTS PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700088002
- **Authorized official:** DR. RANDALL JENKINS MD (DOCTOR)
- **Authorized official phone:** (208) 381-7336

## Contact information

- **Practice address:** 100 E IDAHO ST, 200, BOISE, ID 83712-6223
- **Practice address phone:** (208) 381-7336
- **Practice address fax:** (208) 381-7495
- **Mailing address:** 1935 NW NORFOLK CT, PORTLAND, OR 97229-8448
- **Mailing address phone:** (503) 297-3178
- **Mailing address fax:** (208) 381-7495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0210X | Pediatric Nephrology Physician | M6943 | ID | Yes |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 06/20/2012