Healthcare Provider Details

I. General information

NPI: 1144588971
Provider Name (Legal Business Name): JEFFREY SCOTT MORRISON ATC, LAT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2177 W IRONWOOD CENTER DR
COEUR D ALENE ID
83814-2639
US

IV. Provider business mailing address

5776 W PRAIRIE AVE
POST FALLS ID
83854-5915
US

V. Phone/Fax

Practice location:
  • Phone: 208-625-6111
  • Fax: 208-625-6112
Mailing address:
  • Phone: 509-590-8647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberA1 60306008
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT-779
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: