Healthcare Provider Details

I. General information

NPI: 1790612281
Provider Name (Legal Business Name): RAQUEL KAHLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 S ORCHARD ST STE 100
BOISE ID
83705-1916
US

IV. Provider business mailing address

921 S ORCHARD ST STE 100
BOISE ID
83705-1916
US

V. Phone/Fax

Practice location:
  • Phone: 208-344-9797
  • Fax: 208-344-9898
Mailing address:
  • Phone: 208-344-9797
  • Fax: 208-344-9898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: