Individual
MR. THOMAS POOTOOGOOLUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHA-T
Contact information
Practice address
123 OCEAN VIEW, SHISHMAREF, AK 99772
(907) 649-3311
(907) 649-2083
Mailing address
123 OCEAN VIEW, SHISHMAREF, AK 99772
(907) 649-3311
(907) 649-2083
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHA-T
CHA-T
AK
Enumeration date
01/07/2016
Last updated
01/07/2016
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