# AXIS SPINE PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962944272
- **Authorized official:** JESSICA JAMESON (MD / OWNER)
- **Authorized official phone:** (208) 457-4208

## Contact information

- **Practice address:** 1641 E POLSTON AVE, SUITE 101, POST FALLS, ID 83854-7852
- **Practice address phone:** (208) 457-4208
- **Practice address fax:** (208) 457-4197
- **Mailing address:** 1641 E POLSTON AVE, SUITE 101, POST FALLS, ID 83854-7852
- **Mailing address phone:** (208) 457-4208
- **Mailing address fax:** (208) 457-4197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/17/2016
- **Last updated:** 04/14/2017