Individual
MR. BRETT MICHAEL WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3815 N SCHREIBER WAY UNIT 102, COEUR D ALENE, ID 83815-8434
(208) 667-4557
(208) 765-2887
Mailing address
3815 N SCHREIBER WAY UNIT 102, COEUR D ALENE, ID 83815-8434
(208) 667-4557
(208) 765-2887
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5020
AZ
363A00000X
Physician Assistant
Primary
PA-2640
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75083078
—
CO
Enumeration date
09/26/2011
Last updated
02/03/2026
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