OrganizationActive
Payette Lakes Medical Clinic, PA
NPI 1881725331 · Primary Care Clinic/Center · Council, ID
Provider details
- NPI number
- 1881725331
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Payette Lakes Medical Clinic, PA
- Authorized official
- Jacqueline Bruns, Vp - Physician Services
Practice location
101 Council Avenue
Suite C
Council, ID 83612
Phone: (208) 253-4915
Fax: (208) 253-4917
Mailing address
Po Box 1047
Mccall, ID 83638-1047
Registry dates
- Enumerated
- 2007-03-08
- Last updated
- 2008-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.