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Boise Valley Anesthesia, LLC

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Company Details

Name: Boise Valley Anesthesia, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 14 May 2024 (a year ago)
Financial Date End: 31 May 2026
Entity Number: 5737741
Place of Formation: IDAHO
File Number: 936949
ZIP code: 83646
County: Ada County
Principal Address: 1067 E. AZAN ST MERIDIAN, ID 83646
Mailing Address: 1067 E AZAN ST MERIDIAN, ID 83646-7682

Agent

Name Role Address
Tatiana V Khochay Agent 1067 E AZAN ST, MERIDIAN, ID 83646

Manager

Name Role Address Appointed On
Tatiana Khochay Manager 1067 E. AZAN ST, MERIDIAN, ID 83646 2025-07-03

National Provider Identifier

NPI Number:
1952141418
Certification Date:
2024-06-05

Authorized Person:

Name:
TATIANA KHOCHAY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
367500000X - Certified Registered Nurse Anesthetist
Is Primary:
Yes

Contacts:

Fax:
2085238978

Filing

Filing Name Filing Number Filing date
Annual Report 0006339491 2025-07-03
Initial Filing 0005737741 2024-05-14

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Date of last update: 12 Jul 2025

Sources: Idaho Secretary of State