Individual
JESS PAUL WAYNE PASILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
362 TYEE ST, SOLDOTNA, AK 99669-7631
(907) 714-4521
Mailing address
PO BOX 8292, NIKISKI, AK 99635-8292
(907) 420-4885
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
08/18/2021
Last updated
01/11/2024
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