OrganizationActive
Pain Management of North Idaho, PLLC
NPI 1467583153 · Interventional Pain Medicine Physician · Coeur D Alene, ID
Provider details
- NPI number
- 1467583153
- Entity type
- Organization
- Primary specialty
- Interventional Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Tina Botai, Practice Administrator
- License
- M7860 (ID)
Practice location
1686 W Riverstone Dr
Ste 1
Coeur D Alene, ID 83814-5779
Phone: (208) 765-4807
Fax: (208) 765-2903
Mailing address
1686 W Riverstone Dr
Coeur D Alene, ID 83814-5779
Registry dates
- Enumerated
- 2007-03-07
- Last updated
- 2025-06-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.