Individual
DOROTHY VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
460 RIDGECREST, RM 214, BETHEL, AK 99559
(907) 543-1777
Mailing address
PO BOX 3216, BETHEL, AK 99559-3216
(907) 545-6696
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002573
—
AK
Enumeration date
12/10/2013
Last updated
12/23/2013
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