Healthcare Provider Details

I. General information

NPI: 1407092604
Provider Name (Legal Business Name): JAMIE LYNNE DAVIS DAOM, LAC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2008
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MAIN ST
SANDPOINT ID
83864-1435
US

IV. Provider business mailing address

200 MAIN ST
SANDPOINT ID
83864-1435
US

V. Phone/Fax

Practice location:
  • Phone: 208-264-0644
  • Fax: 888-979-6134
Mailing address:
  • Phone: 208-264-0644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU-348
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC600065362
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00023205
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: