Individual
SHANNON C. THISTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 W IRONWOOD DR STE 320, COEUR D ALENE, ID 83814-4485
(208) 625-5250
(208) 625-5251
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-5084
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2265
ID
363AM0700X
Medical Physician Assistant
MA058013
PA
363AM0700X
Medical Physician Assistant
PA61086741
WA
Other
Enumeration date
08/30/2006
Last updated
07/25/2025
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