Provider Demographics
NPI:1568589596
Name:DWYER & HARRINGTON, PLLC
Entity Type:Organization
Organization Name:DWYER & HARRINGTON, PLLC
Other - Org Name:OMEGA MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-853-0071
Mailing Address - Street 1:5985 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-3039
Mailing Address - Country:US
Mailing Address - Phone:208-853-0071
Mailing Address - Fax:208-853-9422
Practice Address - Street 1:5985 W STATE ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-3039
Practice Address - Country:US
Practice Address - Phone:208-853-0071
Practice Address - Fax:208-853-9422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM71422084P0800X
IDNP722A363L00000X
IDNP458A363L00000X
IDNP424A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1407887623OtherINDIVIDUAL NPI
ID1407887623OtherINDIVIDUAL NPI
ID1136773Medicare ID - Type Unspecified