Organization
CHUGACHMIUT
Active
Other names
Anesia Anahonak Moonin Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY BAKER (HEALTH SERVICES DIVISION DIRECTOR)
(907) 334-0148
Entity
Organization
Contact information
Practice address
63998 GRAHAM ROAD UNIT #3, PORT GRAHAM, AK 99603
(907) 284-2241
(907) 284-2277
Mailing address
1840 BRAGAW ST STE 110, ANCHORAGE, AK 99508-3463
(907) 562-4155
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1581154
—
AK
Enumeration date
03/19/2008
Last updated
12/13/2021
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