LAKE HARBOR INTERNAL MEDICINE (NPI# 1083800015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083800015 |
| Entity Type | Organization |
| Organization Name | LAKE HARBOR INTERNAL MEDICINE |
| Practice Address |
3684 N Harbor Ln Boise ID 83703-6914 |
| Practice Telephone | 2088534556 |
| Practice Fax Number | 2088535544 |
| Mailing Telephone | 2088534556 |
| Mailing Fax Number | 2088535544 |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2007-09-24 |
| Authorized Official Name | DR. KERILYNN ERLAND (OWNER) |
| Authorized Official Telephone | 2088534556 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
3684 N HARBOR LN |
| City | BOISE |
| State | ID |
| Zip Code | 83703-6914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922059146 | Keri Erland | Internal Medicine | 3684 N Harbor Ln, Boise, ID 83703-6914 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203974 | Dylan Roy | Chiropractor | 5632 W State Street, Boise, ID 83703 | 2019-06-07 |
| 1124476858 | Tidwell Social Work Services and Consulting, Inc. | Community/Behavioral Health | 5999 W. State St., Boise, ID 83703 | 2016-06-03 |
| 1801251244 | Rebecca Lynn Cushing | Massage Therapist | 5909 W. State St, Boise, ID 83703 | 2015-12-30 |
| 1790181675 | Malinda Poe | Counselor | 4440 W Taft St, Boise, ID 83703 | 2014-11-05 |
| 1689079469 | Ashley Harker | Massage Therapist | 5909 W. State St., Boise, ID 83703 | 2014-10-23 |
| 1770987844 | Brick House Recovery | Counselor | 3663 N Lakeharbor Ln, Boise, ID 83703 | 2014-10-17 |
| 1033512538 | Ryan Warburton | Physical Therapist | 2999 N Lakeshore Lane, Ste 120, Boise, ID 83703 | 2014-09-29 |
| 1710386008 | Suzanne Iannaccone | Social Worker | 4090 W State St Ste 221, Boise, ID 83703 | 2014-08-22 |
| 1588092464 | Becky L. Marks | Social Worker | 3858 N. Garden Center Way, Suite 204, Boise, ID 83703 | 2013-10-31 |
| 1700219169 | Pohley Richey | Dietitian, Registered | 6052 W State Street, Boise, ID 83703 | 2013-08-20 |
| Find all providers in zip 83703 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851855803 | Lauren Rybarczyk | Specialist | 11498 W Carmichael Dr, Boise, ID 83709-7382 | 2019-01-24 |
| 1851834311 | Tegan Shuman | Specialist | 7307 W San Fernando Dr, Boise, ID 83704-5953 | 2016-11-30 |
| 1952768145 | Katie Garcin | Specialist | 1407 E Boston Dr, Boise, ID 83706 | 2016-01-20 |
| 1093119042 | Robert Porter II | Specialist | 1346 E Candleridge Dr, Boise, ID 83712-6504 | 2014-10-20 |
| 1760885073 | Kelcee Keyes | Specialist | 1705 N Cole Rd, Boise, ID 83704-7304 | 2014-09-30 |
| 1386053213 | Keita Shimada | Specialist | 1910 University Dr # Ms 1020, Boise, ID 83725-0001 | 2014-08-05 |
| 1316373186 | Ralph V Nishitani | Specialist | 9317 W Pandion Ct, Boise, ID 83714-6715 | 2013-09-24 |
| 1548608094 | James Doyce Strong Jr. | Specialist | 3675 S Pimmit Ave, Boise, ID 83706-6416 | 2013-06-06 |
| 1649409269 | Iris Ginron Baker | Specialist | 3555 N Cole Rd, 105, Boise, ID 83704-0733 | 2009-07-02 |
| 1356589931 | Jay T. Ballhagen | Specialist | 10500 W Waterway Ct, Boise, ID 83714-3616 | 2009-02-04 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.