Healthcare Provider Details

I. General information

NPI: 1487502258
Provider Name (Legal Business Name): POLARIS MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 CHURCH ST STE 120
SANDPOINT ID
83864-7065
US

IV. Provider business mailing address

414 CHURCH ST STE 120
SANDPOINT ID
83864-7065
US

V. Phone/Fax

Practice location:
  • Phone: 208-277-9717
  • Fax: 208-435-1862
Mailing address:
  • Phone: 208-277-9717
  • Fax: 208-435-1862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: TESSA REINKE
Title or Position: OWNER/PROVIDER
Credential: MD
Phone: 208-277-9717