Provider Demographics
NPI:1992934103
Name:SPAETE, KARI PAYNTER (AUD)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:PAYNTER
Last Name:SPAETE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1100
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83701-1100
Mailing Address - Country:US
Mailing Address - Phone:208-737-2126
Mailing Address - Fax:
Practice Address - Street 1:172 2ND ST S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3708
Practice Address - Country:US
Practice Address - Phone:208-489-5950
Practice Address - Fax:208-461-5623
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAUD-1872231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDAUD-1872OtherSTATE OF IDAHO BUREAU OF OCCUPATIONAL LICENSES