| Doctor Name: | RICK A YAVRUIAN |
| NPI Number: | 1831131085 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | O-243 |
| Business Practice Address: | 131 N Alumbaugh St Boise, ID - 837049204 |
| Business Phone Number: | 2083672175 |
| Business Fax Number: | 2083760285 |
| Mailing Address: | 3340 E Goldstone Way, MERIDIAN |
| State: | ID |
| Postal Code: | 836421026 |
| Phone Number: | 2083672175 |
| Fax Number: | 2083760285 |
| NPI Enumeration Date: | 06/12/2006 |
| NPI Last Update Date: | 05/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084A0401X |
| License Number: | O-243 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |