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Individual

MS. YELENA SHUEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6533 EMERALD STREET, BOISE, ID 83704-8737
(208) 367-4170
(208) 367-8135
Mailing address
3340 EAST GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-400
ID
363A00000X
Physician Assistant
PA00860
OR
363A00000X
Physician Assistant
Primary
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807884901
ID
05
8078874900
ID
Enumeration date
08/02/2005
Last updated
07/14/2011
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