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Organization

OLGA IRIS WASILE

Active
Other names
Peters Creek Medical Solutions
Organization subpart
No

Provider details

NPI number
Authorized official
DIANE E HODGES (OFFICE MANAGER)
(907) 688-0901
Entity
Organization

Contact information

Practice address
20905 EASTSIDE DR #1, CHUGIAK, AK 99567-1249
(907) 688-0901
(907) 688-0830
Mailing address
PO BOX 671249, CHUGIAK, AK 99567-1249
(907) 688-0901
(907) 688-0830

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1306952569
WASILE NPI
AK
01
4987
OCCUPATIONAL LICENSE
AK
05
MD57672
AK
Enumeration date
03/05/2007
Last updated
06/18/2008
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