Healthcare Provider Details

I. General information

NPI: 1114642923
Provider Name (Legal Business Name): JOANNA WESLEYN SCHAFFER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JO SCHAFFER LMT

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 UNIVERSITY DR
BOISE ID
83725-0001
US

IV. Provider business mailing address

2148 N LIBERTY ST
BOISE ID
83704-7550
US

V. Phone/Fax

Practice location:
  • Phone: 208-426-2158
  • Fax:
Mailing address:
  • Phone: 208-605-2437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: