Organization
ADVANCED DERMATOLOGY OF ALASKA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE GALLER DO (OWNER)
(817) 903-5886
Entity
Organization
Contact information
Practice address
3066 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7254
(907) 357-2332
Mailing address
1100 E DIMOND BLVD STE 103, ANCHORAGE, AK 99515-2001
(907) 232-0251
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1762181
—
AK
Enumeration date
09/29/2025
Last updated
03/25/2026
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