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Contact Information

CLEARWATER MEDICAL CENTER PLLC
1522 17TH ST
LEWISTON, ID83501-3652
 Phone: 208-743-8416
 Fax: 208-743-4642
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for CLEARWATER MEDICAL CENTER PLLC

NPI # 1558452268
LBN Legal business name CLEARWATER MEDICAL CENTER PLLC
Authorized official CELSO CHAVEZ - (OWNER PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 09/27/2006
Last updated 12/16/2008 - About 17 years ago
Identifiers
License # NP361A
ID License # A87025
ID License # NP372A
ID License # NP388A
ID License # NP390A
ID License # NP740A
ID License # NP751A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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