Organization
TANANA CHIEFS CONFERENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOLINE BERGSTROM (HS DIRECTOR)
(907) 452-8251
Entity
Organization
Contact information
Practice address
122 1ST AVE, SUITE 600, FAIRBANKS, AK 99701-4803
(907) 452-8251
Mailing address
122 1ST AVE, SUITE 600, FAIRBANKS, AK 99701-4803
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDG215
—
AK
Enumeration date
05/22/2007
Last updated
05/04/2026
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