# CLEARWATER NEUROSURGERY & SPINAL SURGERY ASSOCIATES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235326208
- **Authorized official:** JEFF J BISHOP (BILLING MANAGER)
- **Authorized official phone:** (509) 684-3606

## Contact information

- **Practice address:** 324 5TH ST, SUITE 101, LEWISTON, ID 83501
- **Practice address phone:** (208) 746-5025
- **Practice address fax:** (208) 746-4946
- **Mailing address:** 324 5TH ST, SUITE 101, LEWISTON, ID 83501-2408
- **Mailing address phone:** (208) 746-5025
- **Mailing address fax:** (208) 746-4946

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | M-4871 | ID | Yes |

## Other

- **Enumeration date:** 10/03/2007
- **Last updated:** 06/04/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7140247 | — | WA |
| 05 | — | 80783320 | — | ID |