Organization
NORTHWOODS FAMILY MEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MYLES STANDISH JR. (REPRESENTATIVE/AGENT)
(206) 300-3992
Entity
Organization
Contact information
Practice address
1301 E. PALMER-WASILLA HWY, #400, WASILLA, AK 99654
(907) 357-9400
Mailing address
PO BOX 876628, WASILLA, AK 99687-6628
(907) 357-9400
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
4823
AK
363AM0700X
Medical Physician Assistant
340
AK
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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