Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Clearwater Medical Center PLLC

Organization Family Medicine Physician · NPI 1558452268

Clearwater Medical Center PLLC provides Family Medicine Physician services in Lewiston, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006
Specialties on file
7
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1522 17th St
Lewiston, ID 83501-3652 Not confirmed with CMS for 17 years — call before visiting
Phone: (208) 743-8416
Fax: (208) 743-4642
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence NP361A
Family Medicine Physician Taxonomy 207Q00000X · Licence A87025 (ID)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence NP740A (ID)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence NP751A (ID)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence NP372A (ID)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence NP388A (ID)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence NP390A (ID)

Record details

NPI number1558452268
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Celso Chavez — Owner Physician · (208) 743-8416
Other names Clearwater Medical Clinic
NPI enumeratedSeptember 27, 2006
Last updated in NPPESDecember 16, 2008
Mailing address1522 17th St, Lewiston, ID 83501-3652

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