Individual
NISSA EGOAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 CHIEF EDDIE HOFFMAN HWY, BETHEL, AK 99559-9955
(907) 543-6452
Mailing address
PO BOX 3427, BETHEL, AK 99559-3427
(907) 543-6452
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/14/2022
Last updated
10/14/2022
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