Individual
OLGA IRIS WASILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20905 EASTSIDE DRIVE #1, CHUGIAK, AK 99567-1249
(907) 688-0901
(907) 688-0830
Mailing address
PO BOX 671249, CHUGIAK, AK 99567-1249
(907) 688-0901
(907) 688-0830
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4987
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD5767
—
AK
Enumeration date
08/21/2006
Last updated
07/09/2007
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