Healthcare Provider Details

I. General information

NPI: 1538074885
Provider Name (Legal Business Name): EVEBREASTFEEDING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 LARCH ST
SANDPOINT ID
83864-1933
US

IV. Provider business mailing address

802 LARCH ST
SANDPOINT ID
83864-1933
US

V. Phone/Fax

Practice location:
  • Phone: 208-610-1049
  • Fax:
Mailing address:
  • Phone: 208-610-1049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State

VIII. Authorized Official

Name: MARIA C WALDEN
Title or Position: NURSE LACTATION CONSULTANT, OWNER
Credential: ANLC IBCLC BSL BSN
Phone: 208-610-1049