| Willow Medical And Wellness | |
|
920 E 72nd Ave Anchorage AK 99518-2810 | |
| (907) 632-7577 | |
| (907) 522-4557 |
| Full Name | Willow Medical And Wellness |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 920 E 72nd Ave, Anchorage, Alaska |
| Authorized Official Name and Position | Eilleen Ha (OWNER) |
| Authorized Official Contact | 9076327577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Medical And Wellness 1407 W 31st Ave Suite 200 Anchorage AK 99503-3678 Ph: (907) 632-7577 | Willow Medical And Wellness 920 E 72nd Ave Anchorage AK 99518-2810 Ph: (907) 632-7577 |
| NPI Number | 1548420920 |
|---|---|
| Provider Enumeration Date | 06/10/2008 |
| Last Update Date | 06/10/2008 |
| Medicare PECOS PAC ID | 5395884035 |
|---|---|
| Medicare Enrollment ID | O20091209000278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548420920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 5089 (Alaska) | Primary |
| Provider Name | Eileen H Ha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760417208 PECOS PAC ID: 3173510856 Enrollment ID: I20040426001508 |
| Provider Name | Deanna R Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427074129 PECOS PAC ID: 6800884677 Enrollment ID: I20050506000737 |
| Provider Name | Keri Deboer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578572756 PECOS PAC ID: 5890710016 Enrollment ID: I20051006000918 |
| Provider Name | Carolyn M Rader |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689625220 PECOS PAC ID: 5597861369 Enrollment ID: I20070511000105 |
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