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TRAVIS J KASSAIULI

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1528563608

Individual Registrant:
 TRAVIS J KASSAIULI 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
315 KWIGUK STREET  EMMONAK, AK 99581 US
Tel: 907-949-3500  Fax: 907-949-3541

Contact information for business:
315 KWIGUK STREET  EMMONAK, AK 99581 US
Tel: 907-949-3500  Fax: 907-949-3541

Registration Information:
NPI: 1528563608
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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