Individual
SHANNA M MCGRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, PA-C, RD, CDE
Contact information
Practice address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 631-7800
Mailing address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 631-7800
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
193
AK
363AM0700X
Medical Physician Assistant
Primary
178095
AK
390200000X
Student in an Organized Health Care Education/Training Program
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193
STATE OF ALASKA LIC
AK
Enumeration date
02/07/2007
Last updated
09/07/2021
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