Healthcare Provider Details

I. General information

NPI: 1013848837
Provider Name (Legal Business Name): JAIDA LAIN HOUGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 OFFICE PARK RD STE 4
WEST DES MOINES IA
50265-2550
US

IV. Provider business mailing address

7296 30TH ST
AURORA IA
50607-9646
US

V. Phone/Fax

Practice location:
  • Phone: 515-882-0800
  • Fax:
Mailing address:
  • Phone: 319-283-8634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number136245
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: