Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Boise Skin Clinic PLLC

Organization Dermatology Physician · NPI 1104220797

Boise Skin Clinic PLLC provides Dermatology Physician services in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2014.

Licensed in
ID
In the registry since
2014
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1636 S Hadley Ave
Boise, ID 83709-2684
Phone: (208) 209-7898
Fax: (208) 258-2079
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence M-9342 (ID)

Record details

NPI number1104220797
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marnie Ririe — Manager · (208) 258-2078
NPI enumeratedOctober 10, 2014
Last updated in NPPESJanuary 22, 2019
Mailing address1636 S Hadley Ave, Boise, ID 83709-2684

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