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

Ada Dermatology, PA

Organization Procedural Dermatology Physician · NPI 1952483299

Ada Dermatology, PA is a Procedural Dermatology Physician in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6454 W Emerald St
Boise, ID 83704-8734
Phone: (208) 377-0820
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Procedural Dermatology Physician (primary) Taxonomy 207NS0135X · Licence M-5274 (ID)

Record details

NPI number1952483299
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Blickenstaff — President · (208) 377-0820
NPI enumeratedOctober 19, 2006
Last updated in NPPESJanuary 30, 2012
Mailing address6454 W Emerald Street, Boise, ID 83704-8734

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