Healthcare Provider Details

I. General information

NPI: 1992632913
Provider Name (Legal Business Name): DALIN ASHTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1401 E CENTRAL DR
MERIDIAN ID
83642-8046
US

IV. Provider business mailing address

1401 E CENTRAL DR
MERIDIAN ID
83642-8046
US

V. Phone/Fax

Practice location:
  • Phone: 208-724-8214
  • Fax:
Mailing address:
  • Phone: 208-724-8214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: