Individual
JAMES IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3356 DALE ST, KETCHIKAN, AK 99901-5626
(907) 225-7825
Mailing address
721 STEDMAN ST, KETCHIKAN, AK 99901-6632
(907) 225-7825
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
02/09/2021
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