Healthcare Provider Details

I. General information

NPI: 1508717380
Provider Name (Legal Business Name): ANCHORED FAMILY PRACTICE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 W IRONWOOD DR STE 100
COEUR D ALENE ID
83814-1402
US

IV. Provider business mailing address

1221 W IRONWOOD DR STE 100
COEUR D ALENE ID
83814-1402
US

V. Phone/Fax

Practice location:
  • Phone: 208-667-8889
  • Fax:
Mailing address:
  • Phone: 208-667-8889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name: PATRICIA A WOODS
Title or Position: OWNER
Credential: MSN, FNP
Phone: 208-667-8889