# DENALI SPECIALTY CLINIC LLC

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

## Provider details

- **NPI number:** 1093683211
- **Authorized official:** MRS. JACQUEE R STEPHENS (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (801) 857-9923

## Contact information

- **Practice address:** 415 MEDICAL DR STE B200, BOUNTIFUL, UT 84010-4986
- **Practice address phone:** (801) 389-4697
- **Mailing address:** 415 MEDICAL DR STE B200, BOUNTIFUL, UT 84010-4986
- **Mailing address phone:** (801) 389-4697

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/28/2025
- **Last updated:** 10/28/2025