Individual
IDA M SEETOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHA-T
Contact information
Practice address
85058 CLARENCE ROAD, BREVIG MISSION, AK 99785
(907) 642-4311
(907) 642-2216
Mailing address
PO BOX 966, NOME, AK 99762-0966
(907) 642-4311
(907) 642-2216
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHA-T
CHA-T
AK
Enumeration date
05/18/2020
Last updated
05/18/2020
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