Individual
MRS. JAMIE MICHELLE DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1551 E MULLAN AVE STE 100, POST FALLS, ID 83854-9005
(208) 262-2482
(208) 262-7460
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2300
(208) 262-2390
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2080
ID
363AM0700X
Medical Physician Assistant
PA-2080
ID
363AS0400X
Surgical Physician Assistant
PA-2080
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144268574
—
ID
Enumeration date
06/04/2006
Last updated
05/27/2025
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