Provider Demographics
NPI:1700219169
Name:RICHEY, POHLEY (BS RD, LD)
Entity Type:Individual
Prefix:
First Name:POHLEY
Middle Name:
Last Name:RICHEY
Suffix:
Gender:F
Credentials:BS RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E HAWAII AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-6011
Mailing Address - Country:US
Mailing Address - Phone:208-463-3244
Mailing Address - Fax:208-463-3388
Practice Address - Street 1:6052 W STATE STREET
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703
Practice Address - Country:US
Practice Address - Phone:208-724-2815
Practice Address - Fax:866-372-4318
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-342133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered