Healthcare Provider Details

I. General information

NPI: 1932063864
Provider Name (Legal Business Name): JAMIN CATES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7905 N MEADOWLARK WAY
COEUR D ALENE ID
83815-5041
US

IV. Provider business mailing address

PO BOX 823
ATHOL ID
83801-0823
US

V. Phone/Fax

Practice location:
  • Phone: 208-762-1250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: