Healthcare Provider Details

I. General information

NPI: 1033996228
Provider Name (Legal Business Name): SANDPOINT ANESTHESIA ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N THIRD AVE
SANDPOINT ID
83864-1507
US

IV. Provider business mailing address

PO BOX 2054
IDAHO FALLS ID
83403-2054
US

V. Phone/Fax

Practice location:
  • Phone: 208-263-1441
  • Fax:
Mailing address:
  • Phone: 208-525-2090
  • Fax: 208-523-8978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: PAMELLA A SCHILLAR
Title or Position: OWNER
Credential: CRNA
Phone: 208-920-1307