Individual
SHANE RUSSELL RALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
230 E MARYDALE AVE, SOLDOTNA, AK 99669-7648
(907) 262-3119
(907) 262-9290
Mailing address
230 E MARYDALE AVE, SOLDOTNA, AK 99669-7648
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
175089
AK
390200000X
Student in an Organized Health Care Education/Training Program
—
WA
Other
Enumeration date
04/12/2017
Last updated
08/16/2021
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