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

Mr. Michael Clyde Graham, PA

Individual provider Physician Assistant · NPI 1205901477

Mr. Michael Clyde Graham, PA is a Physician Assistant in Potlatch, Idaho. Qualified in 1989, 37 years ago. Practices with Kootenai Urgent Care LLC, an 18-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
37
Licensed in
ID
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

225 6th St
Potlatch, ID 83855-5002
Phone: (208) 883-2220
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA594 (ID)

Record details

NPI number1205901477
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 22, 2006
Last updated in NPPESJune 20, 2012

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Group practice Kootenai Urgent Care Llc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Potlatch