Individual
JIE YAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12273 W MCMILLAN RD, BOISE, ID 83713-0555
(208) 367-6330
(208) 367-7393
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-6330
(208) 367-7393
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1218
ID
Other
Enumeration date
12/29/2014
Last updated
02/24/2015
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