Organization
SAINT ALPHONSUS PHYSICIAN SERVICES INC
Active
Other names
Saint Alphonsus Medical Group Federal Way
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANELLE G. REILLY (PRESIDENT)
(208) 367-6490
Entity
Organization
Contact information
Practice address
1880 JUDITH LANE, BOISE, ID 83705-3185
(208) 367-6910
(208) 367-6170
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805276500
—
ID
Enumeration date
06/25/2006
Last updated
08/25/2008
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