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Individual

MS. SAPHIRE DAWN CHRISTINE LARSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PDHA1

Contact information

Practice address
222 TONGASS DR, SITKA, AK 99835-9416
(907) 966-8343
(907) 966-8663
Mailing address
222 TONGASS DR, SITKA, AK 99835-9416
(907) 966-8343
(907) 966-8663

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
19-155-PDHAI
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19-155
PDHA 1
AK
Enumeration date
11/06/2019
Last updated
11/06/2019
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