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Contact Information

STATE OF ALASKA
2800 PROVIDENCE DR
ANCHORAGE, AK99508-4623
 Phone: 907-269-7149
 Fax: 907-269-7251
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for STATE OF ALASKA · (Female)

NPI Number 1811027519
Status Active
Credentials
Entity Individual
Enumeration date 03/06/2007
Last updated 06/16/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • AK License # 4595
  • AK Medicaid MH3990
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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