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MS. CHRISTEN MARRIELLE KING PDHA I
>> Community Health Worker >> Other Service ProvidersRegistrant NPI Number: 1922511385
Individual Registrant:MS. CHRISTEN MARRIELLE KING PDHA I
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
725 RELAY ROAD ANGOON, AK 99820 US
Tel: 907-788-4655 Fax: --
Tel: 907-788-4655 Fax: --
Contact information for business:
3100 CHANNEL DR STE 300 JUNEAU, AK 99801-7837 US
Tel: 907-463-6675 Fax: --
Tel: 907-463-6675 Fax: --
Registration Information:
NPI: 1922511385
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 172V00000X | Other Service Providers Community Health Worker |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| COMMUNITY HEALTH AIDE PROGRAM CERTIFICATION BOARD- FEDERAL CERTIFICATION | 17-144-PDHA1 | 01 |
