Organization
BRISTOL BAY NATIVE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPHY ANDERSEN (CHIEF EXECUTIVE OFFICER)
(907) 842-5257
Entity
Organization
Contact information
Practice address
1000 KANAKANAK ROAD, DILLINGHAM, AK 99576-0310
(907) 842-5257
Mailing address
PO BOX 310, DILLINGHAM, AK 99576-0310
(907) 842-5257
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG473
—
AK
Enumeration date
12/04/2007
Last updated
12/04/2007
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