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General NPI Number Information
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NPI Number | 1154276855
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Entity Type | Organization
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Legal Business Name | PALOUSE HOLISTIC HEALTH & AESTHETICS
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 301 S MAIN ST STE 204
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City | MOSCOW
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State | ID
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Zip | 83843-3058
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Country | US
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Telephone | 208-827-0947
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Fax |
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Provider Business Mailing Address
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Address Line | 1029 LYON RD
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City | MOSCOW
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State | ID
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Zip | 83843-8103
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Country | US
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Telephone | 208-827-0947
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Fax |
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Authorized Official
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Title or Position | OWNER, MEDICAL DIRECTOR
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Name | JENNIFER ROUSE
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Credential | NP
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Telephone | 208-827-0947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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