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IDA M SEETOT CHA-T

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1457974081

Individual Registrant:
 IDA M SEETOT CHA-T
Gender: F
Sole Proprietor

Location and contact information for practice:
85058 CLARENCE ROAD  BREVIG MISSION, AK 99785 US
Tel: 907-642-4311  Fax: 907-642-2216

Contact information for business:
PO BOX 966  NOME, AK 99762-0966 US
Tel: 907-642-4311  Fax: 907-642-2216

Registration Information:
NPI: 1457974081
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker
AK

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CHA-TCHA-TAK01




HEALTH CARE JOBS AK - Page 1



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