Organization
CHUGACHMIUT
Active
Other names
Tatitlek Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY BAKER (HEALTH SERVICES DIVISION DIRECTOR)
(907) 562-4155
Entity
Organization
Contact information
Practice address
505 COPPER MOUNTAIN STREET, TATITLEK, AK 99677
(907) 325-2235
(907) 325-2350
Mailing address
1840 BRAGAW ST STE 110, ANCHORAGE, AK 99508-3463
(907) 562-4155
(907) 563-2891
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021383
—
AK
Enumeration date
03/19/2008
Last updated
09/22/2022
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