| Hpg- Katherine & Kevin Gottlieb Building Cfds | |
|
4441 Diplomacy Dr Anchorage AK 99508-5910 | |
| (907) 729-8880 | |
| Not Available |
| Full Name | Hpg- Katherine & Kevin Gottlieb Building Cfds |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 4441 Diplomacy Dr, Anchorage, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hpg- Katherine & Kevin Gottlieb Building Cfds Po Box 35198 Seattle WA 98124-5198 Ph: () - | Hpg- Katherine & Kevin Gottlieb Building Cfds 4441 Diplomacy Dr Anchorage AK 99508-5910 Ph: (907) 729-8880 |
| NPI Number | 1962040634 |
|---|---|
| Provider Enumeration Date | 12/12/2019 |
| Last Update Date | 09/19/2023 |
| Certification Date | 09/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962040634 | NPI | - | NPPES |
| 1701244 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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