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General NPI Number Information
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NPI Number | 1124974092
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Entity Type | Organization
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Legal Business Name | NORTH IDAHO DPC, PLLC
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 8880 N HESS ST UNIT 1
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City | HAYDEN
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State | ID
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Zip | 83835-8741
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Country | US
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Telephone | 208-772-5204
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Fax | 208-772-5275
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Provider Business Mailing Address
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Address Line | 8880 N HESS ST UNIT 1
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City | HAYDEN
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State | ID
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Zip | 83835-8741
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Country | US
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Telephone | 208-772-5204
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Fax | 208-772-5275
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNA SILAKOSKI
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Credential | DO
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Telephone | 208-772-5204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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