Individual
KISHA DIANNE SMAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BACHELORS
Contact information
Practice address
1550 E 74TH AVE, ANCHORAGE, AK 99507
(907) 929-5826
(907) 929-5862
Mailing address
1550 E 74TH AVE, ANCHORAGE, AK 99507
(907) 929-5826
(907) 929-5862
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
731680
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM5542
—
AK
Enumeration date
01/16/2008
Last updated
02/24/2022
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