Organization
CLEARWATER NEUROSCIENCES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GAIL RICHARDSON (OFFICE MANAGER)
(208) 746-2223
Entity
Organization
Contact information
Practice address
3326 4TH ST STE 6, LEWISTON, ID 83501-4455
(208) 746-2223
(208) 746-2226
Mailing address
3326 4TH ST STE 6, LEWISTON, ID 83501-4455
(208) 746-2223
(208) 746-2226
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932492824
STACY HILL, PH.D.
ID
Enumeration date
11/24/2020
Last updated
11/24/2020
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