Organization
ST LUKES CLINIC-TREASURE VALLEY LLC
Active
Parent organization
ST LUKES HEALTH SYSTEM LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST LUKES HEALTH SYSTEM LTD
Authorized official
KATHRYN FOWLER (SENIOR VP, CFO)
(208) 381-8717
Entity
Organization
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
PO BOX 640, BOISE, ID 83701-0640
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
03
ID
207Q00000X
Family Medicine Physician
Primary
03
ID
207R00000X
Internal Medicine Physician
03
ID
207RC0000X
Cardiovascular Disease Physician
03
ID
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
03
ID
207RH0003X
Hematology & Oncology Physician
03
ID
207V00000X
Obstetrics & Gynecology Physician
03
ID
207W00000X
Ophthalmology Physician
03
ID
208000000X
Pediatrics Physician
03
ID
2080N0001X
Neonatal-Perinatal Medicine Physician
03
ID
2080P0006X
Developmental - Behavioral Pediatrics Physician
03
ID
2084N0400X
Neurology Physician
03
ID
208600000X
Surgery Physician
03
ID
208800000X
Urology Physician
03
ID
208M00000X
Hospitalist Physician
03
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326336058
—
ID
Enumeration date
07/15/2011
Last updated
04/20/2026
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