Individual
IMELDA M HARJONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
670 W FIREWEED LN STE 160, ANCHORAGE, AK 99503-2561
(907) 770-0862
Mailing address
10353 VALLEY PARK DR, ANCHORAGE, AK 99507-7323
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
125195
AK
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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