Emily Dawn Clay, RDN, LD

Individual provider Active NPI Registered Dietitian · Boise, ID

NPI 1659909935 · NPPES record last updated Mar 31, 2020

Key facts

NPI
1659909935
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
D-915 (ID)
Practice address
900 N Liberty St
Boise, ID 83704-8704
Phone
(208) 367-7190
Fax
(208) 367-4505
NPI assigned
Mar 31, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
D-915IDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Boise State Health Center Past
since Dec 13, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D-915 ID Yes

Addresses

Primary practice location

900 N Liberty St
Boise, ID 83704-8704

Mailing address

13407 N 5TH Ave
Boise, ID 83714-9470
Phone (404) 805-3227

Other providers in Boise, ID

All providers in Boise, ID · Registered Dietitian in Idaho

Sources for this page

Verify at the official NPI Registry.