Individual
SHIRLEY M WASSILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHAP
Contact information
Practice address
6000 KANAKANAK RD, DILLINGHAM, AK 99576-0130
(907) 842-5201
(907) 842-9250
Mailing address
P.O. BOX 130, ATTN: CATHY TAYLOR, DILLINGHAM, AK 99576-0130
(907) 842-5201
(907) 842-9250
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
99-316-P
AK
Other
Enumeration date
08/13/2012
Last updated
08/13/2012
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