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

Kieran Doherty, PA-C

Individual provider Physician Assistant · NPI 1457085987

Kieran Doherty, PA-C is a Physician Assistant in Coeur D Alene, Idaho. Qualified in 2023, 3 years ago. Practices with Kootenai Health Inc, a 394-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho and Washington.

Years since qualifying
3
Licensed in
ID, WA
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone: (208) 625-5200
Fax: (208) 625-5201
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 914 S Scheuber Rd, Centralia, WA 98531-9027 — (360) 736-2803

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5971256 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA61487517 (WA)

Record details

NPI number1457085987
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJuly 11, 2022
Last updated in NPPESDecember 18, 2025
Certification dateDecember 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Kootenai Health Inc — 394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Coeur D Alene