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General NPI Number Information
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NPI Number | 1245899269
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Entity Type | Individual
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Provider Name | SARAI GRAVES
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Gender | Female
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 222 N 2ND ST STE 311
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City | BOISE
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State | ID
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Zip | 83702-6131
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Country | US
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Telephone | 208-344-6080
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Fax | 208-344-6079
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Provider Business Mailing Address
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Address Line | 2136 S COLOMA WAY
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City | BOISE
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State | ID
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Zip | 83712-8507
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Country | US
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Telephone | 661-863-8281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TL3256
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2624
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00511
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License Number State | MS
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