Organization
ADA WEST DERMATOPATHOLOGY, LLC
Active
Organization
ADA WEST DERMATOPATHOLOGY, LLC
Active
Parent organization
ADA WEST DERMATOLOGY, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADA WEST DERMATOLOGY, PC
Authorized official
COLLEEN JONES (CFO)
(208) 884-3376
Entity
Organization
Contact information
Practice address
1618 MILLENIUM WAY, STE 220, MERIDIAN, ID 83642-6439
(208) 884-3376
(208) 884-0858
Mailing address
1618 MILLENIUM WAY, STE 220, MERIDIAN, ID 83642-6439
(208) 884-3376
(208) 884-0858
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
P1629
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20002043
MEDICARE PTAN
ID
Enumeration date
08/28/2012
Last updated
05/18/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up