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

Comprehensive Dermatology of Idaho, PLLC

Organization Dermatology Physician · NPI 1386921294

Comprehensive Dermatology of Idaho, PLLC is a Dermatology Physician 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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