| Mr Evan Jacobb Dole, PA | |
|
2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | |
| (208) 625-4000 | |
| (208) 625-4432 |
| Full Name | Mr Evan Jacobb Dole |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 2003 Kootenai Health Way, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780259945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA61569778 (Washington) | Secondary |
| 363A00000X | Physician Assistant | PA-2181 (Idaho) | Primary |
| Entity Name | Whc Physician Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700154226 PECOS PAC ID: 6103093513 Enrollment ID: O20140711000014 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Evan Jacobb Dole, PA 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 Ph: (208) 625-4000 | Mr Evan Jacobb Dole, PA 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 Ph: (208) 625-4000 |
Leah M Streich, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1831 N Lakewood Dr # 1, Coeur D Alene, ID 83814 Phone: 208-215-7199 |
Rebecca Haddad, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2426 N Merritt Creek Loop Ste A, Coeur D Alene, ID 83814 Phone: 208-819-2183 Fax: 208-209-6063 |
Heather Sarkis, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 315 W Dalton Ave, Coeur D Alene, ID 83815 Phone: 208-209-2066 Fax: 208-209-2076 |
Mr. Jeffrey Benson Hargraves, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1090 W Park Pl, Coeur D Alene, ID 83814 Phone: 208-620-5250 |
Kendra Elaine Mcsheridan, Physician Assistant Medicare: Medicare Enrolled Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-5700 Fax: 208-625-5708 |
Bree Ferguson, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 378, Coeur D Alene, ID 83814 Phone: 208-625-3555 Fax: 208-765-1494 |
Taryn Michelle Grattic, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 214 W Sunset Ave, Coeur D Alene, ID 83815 Phone: 208-758-7878 Fax: 800-649-4171 |