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Individual

EVAN DYMENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1360 CALISTA DRIVE, BETHEL, AK 99559-0528
(907) 543-6830
(907) 543-3471
Mailing address
PO BOX 528, ATTN: BH SOBERING CENTER, BETHEL, AK 99559-0528
(907) 543-6830
(907) 543-3471

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020986
AK
Enumeration date
12/09/2015
Last updated
12/09/2015
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