Healthcare Provider Details

I. General information

NPI: 1417878349
Provider Name (Legal Business Name): RILEY GRIGG BEUS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RILEY GRIGG OD

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

762 E WYTHE CREEK CT STE 102
KUNA ID
83634-5215
US

IV. Provider business mailing address

762 E WYTHE CREEK CT STE 102
KUNA ID
83634-5215
US

V. Phone/Fax

Practice location:
  • Phone: 208-922-3060
  • Fax: 208-922-1228
Mailing address:
  • Phone: 208-922-3060
  • Fax: 208-922-1228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4381328
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: