Unknown Individual – Physician Assistant, NPI 1063407484
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
914, West Ironwood Drive, Coeur d'Alene, Kootenai County, Idaho, 83814, United States
COEUR D ALENE, ID 838144927
Phone: (208) 765-5922
Fax: (208) 664-3169
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83814)
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