Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lakeside Pediatric & Adolescent Medicine, PLLC

Organization Pediatric Adolescent Medicine Physician · NPI 1003975087

Lakeside Pediatric & Adolescent Medicine, PLLC is a Pediatric Adolescent Medicine Physician in Coeur D Alene, Idaho. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

980 W Ironwood Dr Ste 302
Coeur D Alene, ID 83814-2601
Phone: (208) 292-5437
Fax: (208) 292-5441
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X

Record details

NPI number1003975087
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diana Vanhook — Office Manager · (208) 292-5437
NPI enumeratedDecember 6, 2006
Last updated in NPPESJuly 12, 2012
Mailing address980 W Ironwood Dr, Ste 302, Coeur D'Alene, ID 83814-2601