Organization
LEWIS CLARK ENDOSCOPY, PLLC
Active
Organization
LEWIS CLARK ENDOSCOPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA LYNN SMITH RN (CLINICAL DIRECTOR)
(208) 298-3002
Entity
Organization
Contact information
Practice address
1630 23RD AVE, SUITE 801, LEWISTON, ID 83501-6345
(208) 298-3002
(208) 743-3369
Mailing address
1630 23RD AVE, SUITE 801, LEWISTON, ID 83501-6345
(208) 298-3002
(208) 743-3369
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807105900
—
ID
Enumeration date
10/17/2005
Last updated
03/22/2012
Update your record
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