Individual
DAMON J PEMBERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1407 W 31ST AVE, STE, 400, ANCHORAGE, AK 99503-3678
(907) 771-0536
(907) 771-0537
Mailing address
1407 W 31ST AVE, STE, 400, ANCHORAGE, AK 99503-3678
(907) 771-0536
(907) 771-0537
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1011
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH005
—
AK
05
—
MH5973
—
AK
Enumeration date
11/19/2010
Last updated
11/19/2010
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