SearchIdahoPhysician Assistant

Van Stonehocker, PA-C

NPI 1649892829 · on the registry since 2020 · sole proprietor

Practice

Address
6641 Kaniksu St
Bonners Ferry, ID 83805
Phone
(208) 267-3655
Fax
(208) 267-3757
Organisation at this address
Main Street Medical Llc
Ernest A. Lucero, Md Pc
Boundary Community Hospital
Inferred from a shared address, not stated in the registry.
Clinicians at this address
6

Registry record

Primary taxonomy
Physician Assistant
363A00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-01-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho