Jessica Dickson
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Moscow, ID
NPI 1497686398 · NPPES record last updated May 28, 2026
Key facts
- NPI
- 1497686398
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 875 Perimeter Dr
Moscow, ID 83844-9803 - Phone
- (208) 885-6111
- NPI assigned
- May 28, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
875 Perimeter Dr
Moscow, ID 83844-9803
Mailing address
349 Maple St
Evanston, WY 82930-2673
Other providers in Moscow, ID
- Jamie C. Derrick
- Susan A Derry
- Kimberly Ann Devich
- Carley Shawn Devore
- Tami Lynn Dial
- Amanda Dienno
- Patricia Ann Dillon
- Claire Ann Dines
- Samantha Dingman
- Disability Action Center
All providers in Moscow, ID · Student in an Organized Health Care Education/Training Program in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.