NPIMap

Organization Active NPI

Cda Wellness

  • Health Service Clinic/Center
  • Rathdrum, ID
National Provider Identifier
1700616190
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
CDA WELLNESS
Practice address
6299 W Alliance St
Rathdrum, ID 83858-0139
Phone
(208) 518-8111
Fax
(208) 599-9787
NPI assigned
Aug 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Katiuska Alexandra Vestman, PMHNPNPI 1164288452
Title
Owner
Phone
(208) 518-8111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

6299 W Alliance St
Rathdrum, ID 83858-0139

Mailing address

6299 W Alliance St
Rathdrum, ID 83858-0139
Phone (208) 518-8111

Other names 1

  • CDA Wellness Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cda Wellness2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1700616190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6299 W ALLIANCE ST",
            "city": "RATHDRUM",
            "state": "ID",
            "postal_code": "838580139",
            "telephone_number": "208-518-8111",
            "fax_number": "208-900-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6299 W ALLIANCE ST",
            "city": "RATHDRUM",
            "state": "ID",
            "postal_code": "838580139",
            "telephone_number": "208-518-8111",
            "fax_number": "208-599-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDA WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-01",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "VESTMAN",
        "authorized_official_first_name": "KATIUSKA",
        "authorized_official_middle_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-518-8111",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CDA Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CDA Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rathdrum, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.