Provider Demographics
NPI:1891051942
Name:YE-LIEW, LOUISE XIAN (DO)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:XIAN
Last Name:YE-LIEW
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LOUISE
Other - Middle Name:XIAN
Other - Last Name:YE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
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:208-225-6858
Practice Address - Street 1:2965 EAST TARPON
Practice Address - Street 2:SUITE 150
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642
Practice Address - Country:US
Practice Address - Phone:208-509-8987
Practice Address - Fax:208-225-6858
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12437207Q00000X
IDO-1288208M00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB216713Medicare PIN