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

Brian E Granvall, PA-C

Individual provider Physician Assistant · NPI 1205809852

Brian E Granvall, PA-C is a Physician Assistant in Boise, Idaho. Licensed in Idaho, Maryland, Oregon and Virginia and 1 more. Registered with an NPI since 2006.

Licensed in
ID, MD, OR, VA, WA
In the registry since
2006
Specialties on file
5
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-2094
Fax: (208) 381-1791
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Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence PA-1042 (ID)
Physician Assistant Taxonomy 363A00000X · Licence 0110002940 (VA)
Physician Assistant Taxonomy 363A00000X · Licence PA10004399 (WA)
Physician Assistant Taxonomy 363A00000X · Licence PA 00846 (OR)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence C04233 (MD)

Record details

NPI number1205809852
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 13, 2006
Last updated in NPPESJanuary 31, 2022
Mailing addressPo Box 1108, Corvallis, OR 97339-1108

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