Organization
TANANA CHIEFS CONFENERCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOLINE BERGSTROM (HEALTH DIRECTOR)
(907) 452-8251
Entity
Organization
Contact information
Practice address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 452-6682
Mailing address
PO BOX 94429, SEATTLE, WA 98124-6729
(907) 452-6682
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AK
Enumeration date
10/03/2017
Last updated
07/26/2024
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