Individual
ELSBETH CHIYO JENSEN-OTSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
500 W. FORT ST., # 111, BOISE, ID 83702
(208) 422-1315
(208) 422-1319
Mailing address
500 W. FORT ST., # 111, BOISE, ID 83702
(208) 422-1315
(208) 422-1319
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
53498
CO
207RG0100X
Gastroenterology Physician
Primary
M-14213
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2011
Last updated
07/01/2022
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