Organization
BOISE VALLEY ASTHMA & ALLERGY PA
Active
Other names
Boise Valley Asthma And Allergy Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN WAUGH (INSURANCE/CREDENTIALING ADMIN)
(208) 378-0080
Entity
Organization
Contact information
Practice address
901 N CURTIS RD STE 100, BOISE, ID 83706-1339
(208) 378-0080
(208) 378-0259
Mailing address
901 N CURTIS RD, SUITE 100, BOISE, ID 83706-1394
(208) 378-0080
(208) 378-0259
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215061734
—
ID
01
—
1374345
MEDICARE PTAN
ID
Enumeration date
03/15/2007
Last updated
05/08/2026
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