Provider Demographics
NPI:1174993463
Name:KARAS, DARIA ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:DARIA
Middle Name:ELIZABETH
Last Name:KARAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:DARIA
Other - Middle Name:ELIZABETH
Other - Last Name:KANEVSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8000 S. FEDERAL WAY, MAIL STOP 1-706
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716
Mailing Address - Country:US
Mailing Address - Phone:208-368-5656
Mailing Address - Fax:208-368-5607
Practice Address - Street 1:8000 S. FEDERAL WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83716
Practice Address - Country:US
Practice Address - Phone:208-368-5656
Practice Address - Fax:208-368-5607
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA-1300363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDPA1300OtherIDAHO BOARD OF MED