Individual
LARA J WONGITTILIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCA
Contact information
Practice address
PO BOX 966, NOME, AK 99762-0966
(907) 443-9603
(907) 443-8177
Mailing address
1000 GREG KRUSHEK AVE, NOME, AK 99762-0966
(907) 443-3311
(907) 443-3471
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
3747P1801X
Personal Care Attendant
Primary
—
AK
Other
Enumeration date
05/08/2025
Last updated
01/20/2026
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