Individual
ALICIA KOSTELECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1818 E REZANOF DR, KODIAK, AK 99615-6505
(907) 481-2400
Mailing address
PO BOX 3290, PORTLAND, OR 97208-3290
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/14/2023
Last updated
06/05/2023
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