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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DEREK SCOTT AHLSTROM, PA

Active

Physician Assistant · BOISE, ID

Registration Details

NPI Number
1174096606
Provider Type
Individual
Gender
Male
NPI Issued
Jan 8, 2019 (7.2828069681971 yrs)
Last Updated
Mar 28, 2024
Licenses
PA61522965 (WA)
PA-1715 (ID)

Practice Information

Address
7941 W RIFLEMAN ST
BOISE, ID, 837049001
Browse ID providers · Browse ZIP 83704
Phone
2088957950
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in BOISE, ID

Name Credential NPI
MS. YELENA SHUEY PA-C 1124029939
JEFFREY D SMITH PA C 1013905793
CHADWICK ALDEN FISHER PA 1497744338
RACHEL KING PA 1205826245
DARRELL L KING PA 1770573644
THOMAS F DOUTHIT PA-C 1023008414
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.