Individual
JENNIFER N RISTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1072 N LIBERTY ST STE 201, BOISE, ID 83704-8708
(208) 302-2400
(208) 302-2455
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2224
ID
Other
Enumeration date
02/15/2022
Last updated
12/08/2025
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