Individual
JACQUELYN LOUISE SERRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
1201 E 36TH AVE, ANCHORAGE, AK 99508-4372
(907) 562-9229
(907) 562-1603
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7210
AK
207Q00000X
Family Medicine Physician
MD25784
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200598
L & I
WA
05
—
1574175
—
AK
05
—
8434375
—
WA
01
—
911019392
COMMERCIAL
—
Enumeration date
08/31/2006
Last updated
03/07/2023
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