KATIE DIANA WAITES

BOISE, ID
NPI1306964994
Former NameKATIE DIANA MALLABURN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-1501)
Enumeration Date2007-03-26
Last Update Date2025-04-04
Business Address
Mrs. KATIE DIANA WAITES PA-C
701 E PARKCENTER BLVD
BOISE, ID 83706-6528
Phone number: 208-381-4210
Mailing Address
Mrs. KATIE DIANA WAITES PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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