# EAR, NOSE & THROAT OF COEUR D'ALENE, PA

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

## Provider details

- **NPI number:** 1427103753
- **Authorized official:** MS. SHARI KANE (OFFICE MANAGER)
- **Authorized official phone:** (208) 765-1345

## Contact information

- **Practice address:** 700 W IRONWOOD DRIVE, SUITE 236, COEUR D'ALENE, ID 83814-4484
- **Practice address phone:** (208) 765-1345
- **Practice address fax:** (208) 667-9622
- **Mailing address:** 700 W IRONWOOD DRIVE, SUITE 236, COEUR D'ALENE, ID 83814-4484
- **Mailing address phone:** (208) 765-1345
- **Mailing address fax:** (208) 667-9622

## Taxonomy

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

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000010006189 | REGENCE GROUP \# | ID |
| 05 | — | 002705200 | — | ID |
| 05 | — | 7125115 | — | WA |
| 01 | — | 88799 | BLUE CROSS GROUP \# | ID |