Individual
RACHEL KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6454 W EMERALD ST, BOISE, ID 83704-8734
(208) 377-0820
(208) 375-8046
Mailing address
6454 W EMERALD ST, BOISE, ID 83704-8734
(208) 377-0820
(208) 375-8046
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA521
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010148622
BLUE SHIELD
ID
01
—
000010148623
BLUE SHIELD
ID
05
—
807029900
—
ID
01
—
PACD0
BLUE CROSS
ID
01
—
PAMR8
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
07/21/2021
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