Organization
EAR, NOSE & THROAT OF COEUR D'ALENE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARI KANE (OFFICE MANAGER)
(208) 765-1345
Entity
Organization
Contact information
Practice address
700 W IRONWOOD DRIVE, SUITE 236, COEUR D'ALENE, ID 83814-4484
(208) 765-1345
(208) 667-9622
Mailing address
700 W IRONWOOD DRIVE, SUITE 236, COEUR D'ALENE, ID 83814-4484
(208) 765-1345
(208) 667-9622
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010006189
REGENCE GROUP #
ID
05
—
002705200
—
ID
05
—
7125115
—
WA
01
—
88799
BLUE CROSS GROUP #
ID
Enumeration date
01/25/2007
Last updated
07/21/2022
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