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

Intermountian Pediatric Clinic PA

Organization Family Medicine Physician · NPI 1093551319

Intermountian Pediatric Clinic PA is a Family Medicine Physician in Boise, Idaho. Registered with an NPI since 2024.

In the registry since
2024
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

7722 W Ustick Rd
Boise, ID 83704-5845
Phone: (208) 322-1325
Fax: (208) 327-0393
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1093551319
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Karen Jambura — Office Manager · (208) 322-1325
NPI enumeratedJuly 5, 2024
Last updated in NPPESJuly 5, 2024
Certification dateJuly 5, 2024
Mailing address7722 W Ustick Rd, Boise, ID 83704-5845

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