Healthcare Provider Details

I. General information

NPI: 1992621940
Provider Name (Legal Business Name): JALANE CHRISTENSON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13150 W PERSIMMON LN
BOISE ID
83713-1986
US

IV. Provider business mailing address

7851 E HILTON HEAD ST
NAMPA ID
83687-1176
US

V. Phone/Fax

Practice location:
  • Phone: 208-519-2685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAS-5153
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: