Individual
IRENE BULAONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1825 ADONIS DR, ANCHORAGE, AK 99515-4511
(907) 350-3606
Mailing address
11615 FRANCES ELAINE CIR, ANCHORAGE, AK 99515-3396
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
741060
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL2354
—
AK
Enumeration date
09/26/2007
Last updated
09/26/2007
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