Organization
ADA WEST DERMATOLOGY, PC
Active
Organization
ADA WEST DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN JONES (CFO)
(208) 884-3376
Entity
Organization
Contact information
Practice address
1618 S MILLENIUM WAY STE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Mailing address
1618 S. MILLENNIUM WAY, SUITE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M5986
ID
Other
Enumeration date
08/01/2006
Last updated
05/18/2026
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