Individual
KAREN SHIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OP
Contact information
Practice address
1919 LATHROP ST, SUITE 103, FAIRBANKS, AK 99701
(800) 478-4091
(907) 451-7184
Mailing address
PO BOX 241769, ANCHORAGE, AK 99524-1769
(909) 770-2380
(909) 770-2390
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DOP D 44
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0194434
DEPT OF LABOR GROUP
AK
01
—
A0330
BLUE CROSS
AK
05
—
OP0593
—
AK
Enumeration date
01/30/2006
Last updated
07/08/2007
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