Provider Demographics
NPI:1437857729
Name:EAST WEST DPC
Entity Type:Organization
Organization Name:EAST WEST DPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:YE-LIEW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:208-509-8987
Mailing Address - Street 1:141 N PALMETTO AVE UNIT 602
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-8025
Mailing Address - Country:US
Mailing Address - Phone:208-509-8987
Mailing Address - Fax:
Practice Address - Street 1:1524 W CAYUSE CREEK DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-4795
Practice Address - Country:US
Practice Address - Phone:208-509-8987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty