Provider Demographics
NPI:1790677375
Name:ANDERSON, RILEY PAIGE (PA-C)
Entity type:Individual
Prefix:MS
First Name:RILEY
Middle Name:PAIGE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8915 W SHELLIE LN
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-6947
Mailing Address - Country:US
Mailing Address - Phone:253-431-4785
Mailing Address - Fax:
Practice Address - Street 1:5080 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-5513
Practice Address - Country:US
Practice Address - Phone:208-489-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant