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Individual

SHAWN GILLETT ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
10583 W LAKE HAZEL RD, BOISE, ID 83709
(208) 302-5950
(208) 302-5955
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642
(208) 302-5950
(208) 302-5955

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-886
ID
363A00000X
Physician Assistant
PA211907
OR
363AM0700X
Medical Physician Assistant

Other

Enumeration date
02/21/2007
Last updated
02/17/2023
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