Healthcare Provider Details

I. General information

NPI: 1063204782
Provider Name (Legal Business Name): JAIME L SIMKINS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12812 OLD GLENN HWY
EAGLE RIVER AK
99577-7002
US

IV. Provider business mailing address

11535 ECHO ST
EAGLE RIVER AK
99577-7865
US

V. Phone/Fax

Practice location:
  • Phone: 907-696-8020
  • Fax:
Mailing address:
  • Phone: 907-854-7390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number236359
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: