Individual
ANGELES M TAVIRA-DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DIRECTOR, OWNER
Contact information
Practice address
1301 WINTERGREEN ST, ANCHORAGE, AK 99508-3069
(907) 770-6315
(907) 770-1241
Mailing address
1301 WINTERGREEN ST, ANCHORAGE, AK 99508-3069
(907) 770-6315
(907) 770-1241
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
436017
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PCG224
—
AK
Enumeration date
04/03/2007
Last updated
07/09/2007
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