Provider Demographics
NPI:1275755449
Name:STRINGER, PAUL EVERETT (TCM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:EVERETT
Last Name:STRINGER
Suffix:
Gender:M
Credentials:TCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11639 W GINGER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-3654
Mailing Address - Country:US
Mailing Address - Phone:801-458-8232
Mailing Address - Fax:
Practice Address - Street 1:11639 W GINGER CREEK DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-3654
Practice Address - Country:US
Practice Address - Phone:801-458-8232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT260022408OtherRAILROAD MEDICARE
UT876000308007Medicaid