Healthcare Provider Details

I. General information

NPI: 1972416485
Provider Name (Legal Business Name): JORDYN ELIZABETH JENE SAWYER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1276 W RIVER ST STE 100
BOISE ID
83702-7083
US

IV. Provider business mailing address

33711 HIGHWAY 95
LEWISTON ID
83501-7953
US

V. Phone/Fax

Practice location:
  • Phone: 208-338-4699
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1181935
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: