Provider Demographics
NPI:1871370544
Name:DOBSON, MICHELLE ASHLEY (CSFA, CSA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ASHLEY
Last Name:DOBSON
Suffix:
Gender:F
Credentials:CSFA, CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N ROBBINS RD STE 400
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-4566
Mailing Address - Country:US
Mailing Address - Phone:208-706-2663
Mailing Address - Fax:208-489-3300
Practice Address - Street 1:600 N ROBBINS RD STE 400
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4566
Practice Address - Country:US
Practice Address - Phone:208-706-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID195801246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant