NPI age
12 years
Enumerated 2013-11-07
● Active Type 2 · Organization
Passport Health Holdings, Llc
Passport Health Holdings, Llc is 1 of 145 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Fishburn
Chief Operating Officer
Last NPPES update
2022-04-01
Source: monthly bulk 2026-05
How this organization compares
Across 145 active clinic/center providers in Idaho.
NPI age
12 years
↑ 3 yr above median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 9% of peers with subspecialties
NPI lifetime · 2013 → 2026
2013-11Enumerated in NPPES
2013
2026
Where they practice
Primary practice location
910 Main St, Suite 352
Boise, ID 837025720
Mailing address
668 N 44th St, Suite 100w
Phoenix, AZ 850086507
Authorized official
Paul Fishburn
Chief Operating Officer
📞 4806469020
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Christine Drouillard, LCSW Social Worker NPI 1104075225
- Angela Hidalgo Massage Therapist NPI 1720380298
Specialties
-
Clinic/Center PrimaryA facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct...
-
Preventive MedicinePublic health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Passport Health
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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