Allison Lee Etnyre, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-202238 Issued in ID

Practice address

1070 N Curtis Rd
Suite 210
Boise, ID 83706-1238

Phone

(208) 860-0770

Fax

(208) 322-0367

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 10, 2008.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1619001005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11368 W HICKORY BARK DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131004",
            "telephone_number": "208-323-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 N CURTIS RD",
            "address_2": "SUITE 210",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061238",
            "telephone_number": "208-860-0770",
            "fax_number": "208-322-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETNYRE",
        "first_name": "ALLISON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY-202238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "N6135",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010158559",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002269500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael E. Estess, M. D.
• Luchette Esteves, APRN
• John M Etchart, MD
• Linsey Etherington, MD
• Sajjad Etminan
• Louis Eubank, M.D.
• Evan Hathaway DDS PA
• Cade Evander
• Evans Anesthesia Services PC
• Athena Denice Evans-Campbell

• All providers in Boise, ID
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.