Individual
ZACHERY LAVENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDMT-P
Contact information
Practice address
2630 CENTRAL AVE, EIELSON AFB, AK 99702-2301
(907) 377-7835
Mailing address
2630 CENTRAL AVE, EIELSON AFB, AK 99702-2301
(907) 377-7835
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
12/20/2023
Last updated
10/07/2025
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