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Contact Information

CRYSTAL L STORDAHL, PHYSICIAN ASSISTANT
1408 19TH AVE
FAIRBANKS, AK99701-5903
 Phone: 907-452-8251
 Fax: 907-459-3978
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for CRYSTAL L STORDAHL · (Female)

NPI # 1760505192
Status Active
Credentials PHYSICIAN ASSISTANT
Entity Individual
Enumeration date 04/09/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • AK License # 518
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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