Organization
FUNCTIONAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY PASOL OTR (OTR)
(907) 334-9002
Entity
Organization
Contact information
Practice address
6613 BRAYTON DR, SUITE A, ANCHORAGE, AK 99507-2127
(907) 334-9002
(907) 334-9320
Mailing address
PO BOX 113394, ANCHORAGE, AK 99511-3394
(907) 334-9002
(907) 334-9320
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
AK
225XP0200X
Pediatric Occupational Therapist
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OT1318
—
AK
05
—
OT32411
—
AK
05
—
OT45641
—
AK
05
—
PT2352
—
AK
Enumeration date
02/20/2007
Last updated
09/11/2025
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