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General NPI Number Information
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NPI Number | 1891051942
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Entity Type | Individual
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Provider Name | LOUISE XIAN YE-LIEW D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 2965 EAST TARPON SUITE 150
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-509-8987
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Fax | 208-225-6858
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Provider Business Mailing Address
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Address Line | 141 N PALMETTO AVE UNIT 602
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City | EAGLE
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State | ID
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Zip | 83616-8025
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Country | US
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Telephone | 208-509-8987
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Fax | 208-225-6858
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A12437
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | O-1288
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | O-1288
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License Number State | ID
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