Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Comprehensive Dermatology of Idaho, PLLC

Organization Dermatology Physician · NPI 1386921294

Comprehensive Dermatology of Idaho, PLLC provides Dermatology Physician services in Nampa, Idaho. Licensed in Idaho. Registered with an NPI since 2011.

Licensed in
ID
In the registry since
2011
Specialties on file
2
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

16111 N Brinson St Ste 100
Nampa, ID 83687-5509
Phone: (208) 467-7546
Fax: (208) 467-7500
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence M8483 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA280 (ID)

Record details

NPI number1386921294
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ryan Owsley — Owner · (208) 467-7546
NPI enumeratedNovember 5, 2011
Last updated in NPPESDecember 23, 2019
Certification dateDecember 23, 2019
Mailing address16111 N Brinson St Ste 100, Nampa, ID 83687-5509

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