Eastern Aleutian Tribes, Inc | |
100 Slocum Drive King Cove AK 99612 | |
(907) 497-2311 | |
(907) 497-2310 |
Full Name | Eastern Aleutian Tribes, Inc |
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Speciality | Clinic/Center |
Location | 100 Slocum Drive, King Cove, Alaska |
Authorized Official Name and Position | Jennifer Harrison (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9072771440 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Eastern Aleutian Tribes, Inc 3380 C St Suite 100 Anchorage AK 99503-3920 Ph: (907) 277-1440 | Eastern Aleutian Tribes, Inc 100 Slocum Drive King Cove AK 99612 Ph: (907) 497-2311 |
NPI Number | 1649332446 |
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Provider Enumeration Date | 12/15/2006 |
Last Update Date | 04/13/2015 |
Medicare PECOS PAC ID | 2860301884 |
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Medicare Enrollment ID | O20180413000684 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649332446 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | (Alaska) | Primary |
Provider Name | Catherine Mizen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760465025 PECOS PAC ID: 0941104459 Enrollment ID: I20031125000500 |
Provider Name | Katherine L Sterner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003860164 PECOS PAC ID: 1355244054 Enrollment ID: I20040129001129 |
Provider Name | Lynn E Gras |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578528006 PECOS PAC ID: 5597735142 Enrollment ID: I20040729001353 |
Provider Name | Sandra Roberts |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083653836 PECOS PAC ID: 0648226860 Enrollment ID: I20050330000564 |
Provider Name | Patricia Delate |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629081393 PECOS PAC ID: 7719920594 Enrollment ID: I20050602000621 |
Provider Name | Shanda R Lohse |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790891521 PECOS PAC ID: 0042255325 Enrollment ID: I20050627001181 |
Provider Name | Pornson P Linton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104017755 PECOS PAC ID: 1052347879 Enrollment ID: I20050714001019 |
Provider Name | June I Morgan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396858114 PECOS PAC ID: 9032297304 Enrollment ID: I20080428000248 |
Provider Name | Chadwick Johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821010109 PECOS PAC ID: 9638154164 Enrollment ID: I20100802000509 |
Provider Name | Karen Jackman |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1073633491 PECOS PAC ID: 7214820398 Enrollment ID: I20110910002947 |
Provider Name | Yusef Ghamarian |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558797217 PECOS PAC ID: 4082845227 Enrollment ID: I20140401000750 |
Provider Name | Lesley K De Jaray |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700171030 PECOS PAC ID: 5395916167 Enrollment ID: I20140731002529 |
Provider Name | Selanie A Sanone |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932380839 PECOS PAC ID: 4981502358 Enrollment ID: I20141029001559 |
Provider Name | Kenneth Wallenfelsz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457649998 PECOS PAC ID: 0749433506 Enrollment ID: I20141230000263 |
Provider Name | Aaron R Whittington |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497138101 PECOS PAC ID: 4587979331 Enrollment ID: I20150824000020 |
Provider Name | Sara A Stetson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124491501 PECOS PAC ID: 4587969209 Enrollment ID: I20160217002616 |
Provider Name | Dawn R Lovisa |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841212321 PECOS PAC ID: 3779776158 Enrollment ID: I20160316000197 |
Provider Name | Molly Rothmeyer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639238652 PECOS PAC ID: 0547458309 Enrollment ID: I20160421000227 |
Provider Name | Drew D Dorschner |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1134582653 PECOS PAC ID: 2769771419 Enrollment ID: I20160519000142 |
Provider Name | Mary I Jones |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508823584 PECOS PAC ID: 6103833355 Enrollment ID: I20161101001892 |
Provider Name | Rebecca Sturdevant |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396802112 PECOS PAC ID: 0143120402 Enrollment ID: I20170803002864 |
Provider Name | Cynthia L Sherwood |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942554050 PECOS PAC ID: 3678718293 Enrollment ID: I20171005000060 |
Provider Name | Danita N Koehler |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1750455150 PECOS PAC ID: 9638193659 Enrollment ID: I20180412002429 |
Provider Name | Riley H Wyna |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760982581 PECOS PAC ID: 4183987704 Enrollment ID: I20180413000148 |
Provider Name | Kathleen C Rooney |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932351871 PECOS PAC ID: 3173686094 Enrollment ID: I20180418002075 |
Provider Name | Terri L Douglas |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396018818 PECOS PAC ID: 7416110952 Enrollment ID: I20180509002140 |
Provider Name | Cameron A Karlsen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316245509 PECOS PAC ID: 6305022518 Enrollment ID: I20180823002619 |
Provider Name | Maureen A Cox |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114190048 PECOS PAC ID: 6800960774 Enrollment ID: I20180911001981 |
Provider Name | Rebecca A Biersbach |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235564212 PECOS PAC ID: 8729213236 Enrollment ID: I20181108002756 |
Provider Name | John Hugh Wallace |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003296484 PECOS PAC ID: 0446567127 Enrollment ID: I20190305001248 |
Provider Name | Jill S Cease |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245284249 PECOS PAC ID: 3971503269 Enrollment ID: I20190417000304 |
Provider Name | Richard Fitzgerald Mccoy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902314511 PECOS PAC ID: 9931468725 Enrollment ID: I20190417000351 |
Provider Name | Walter Argueta |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508333717 PECOS PAC ID: 0749521854 Enrollment ID: I20190417001995 |
Provider Name | Carol J Borg |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356394282 PECOS PAC ID: 1557364486 Enrollment ID: I20190617001105 |
Provider Name | Colleen Slate |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922246503 PECOS PAC ID: 0547317125 Enrollment ID: I20190826000564 |
Provider Name | Krysta Byrnes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073027942 PECOS PAC ID: 1456689314 Enrollment ID: I20190830000119 |
Provider Name | Gregory Bryant Proulx |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982038063 PECOS PAC ID: 6204065790 Enrollment ID: I20190830002305 |
Provider Name | Kadijatu Kakay |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992051270 PECOS PAC ID: 3274862479 Enrollment ID: I20190913001198 |
Provider Name | Megan Ryan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528566098 PECOS PAC ID: 3870824428 Enrollment ID: I20191011001232 |
Provider Name | Brittany Chambers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871851022 PECOS PAC ID: 5799948873 Enrollment ID: I20191017000600 |
Provider Name | Mary Mackenburg Mohn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073690012 PECOS PAC ID: 3577716158 Enrollment ID: I20191118001061 |
Provider Name | Shelly Alexander |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881008498 PECOS PAC ID: 9436379237 Enrollment ID: I20191218000720 |
Provider Name | Jyll K Green |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932260627 PECOS PAC ID: 1557388535 Enrollment ID: I20200107000199 |
Provider Name | Stacy L Newbern |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386020352 PECOS PAC ID: 9436499910 Enrollment ID: I20200107000547 |
Provider Name | Tracey L Carter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306247796 PECOS PAC ID: 4284926254 Enrollment ID: I20200128000038 |
Provider Name | Hunter M Keys |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649696279 PECOS PAC ID: 2668697624 Enrollment ID: I20200206000136 |
Provider Name | Timothy Michael Pruitt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295738706 PECOS PAC ID: 9931131943 Enrollment ID: I20201230000640 |
Provider Name | Brandon L Young |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609199629 PECOS PAC ID: 9537299573 Enrollment ID: I20210426001126 |
Provider Name | Kristen A Baker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124572540 PECOS PAC ID: 7416235627 Enrollment ID: I20210511000363 |
Provider Name | Jeffrey L Bevan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700992898 PECOS PAC ID: 1951300136 Enrollment ID: I20210527001957 |
Provider Name | Lisa A Langburd |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558329664 PECOS PAC ID: 6800848284 Enrollment ID: I20210527002542 |
Provider Name | Charissa M Kamps |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821361650 PECOS PAC ID: 6709047020 Enrollment ID: I20210601000690 |
Provider Name | Christopher R Hemmer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700802659 PECOS PAC ID: 2264455633 Enrollment ID: I20210913003367 |
Provider Name | Decca Singletary |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174932230 PECOS PAC ID: 4688993058 Enrollment ID: I20220216000133 |
Provider Name | Richard E Steel |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205016151 PECOS PAC ID: 4688751704 Enrollment ID: I20220712001490 |
Provider Name | Linnea A Trageser |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275563280 PECOS PAC ID: 6901932300 Enrollment ID: I20220713002656 |
Provider Name | Sarah J Kelley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700214749 PECOS PAC ID: 0446487920 Enrollment ID: I20220927000264 |
Provider Name | Mary Sawyer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477917391 PECOS PAC ID: 6406144302 Enrollment ID: I20230111000609 |
Provider Name | Justin M Dowd |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316563927 PECOS PAC ID: 2264855840 Enrollment ID: I20230317000414 |
Provider Name | Rachel Fortes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083852263 PECOS PAC ID: 3375609191 Enrollment ID: I20230424001109 |
Provider Name | Karen Lynn Lewis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306194576 PECOS PAC ID: 5890937726 Enrollment ID: I20230613001642 |
Provider Name | Peggy L Knowski |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497093264 PECOS PAC ID: 3072758663 Enrollment ID: I20230810000044 |
Provider Name | Deborah Cox |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770908964 PECOS PAC ID: 2264663335 Enrollment ID: I20231128001233 |
Provider Name | Kathleen M Core |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013989904 PECOS PAC ID: 5890952444 Enrollment ID: I20231130000450 |
Provider Name | Nicole Shirvani |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1295175347 PECOS PAC ID: 7315215522 Enrollment ID: I20231204000874 |
Provider Name | Loretta B Charles |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912341306 PECOS PAC ID: 0446474811 Enrollment ID: I20231214000153 |
Provider Name | Charles Morgan |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1275065922 PECOS PAC ID: 8426461047 Enrollment ID: I20240531000412 |
Provider Name | Bailey Alvarez |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1912444936 PECOS PAC ID: 0042642647 Enrollment ID: I20240606003908 |
Provider Name | Gwen Cedfeldt |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1053947796 PECOS PAC ID: 0244689511 Enrollment ID: I20240613000902 |
Provider Name | Jasmine Allen |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1508587411 PECOS PAC ID: 3274999321 Enrollment ID: I20240613001710 |
Provider Name | Anne Chambers |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1427718428 PECOS PAC ID: 8022475193 Enrollment ID: I20240613002070 |
Provider Name | Rebecca Ohlson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1043793920 PECOS PAC ID: 6901263367 Enrollment ID: I20240613002815 |
Provider Name | Kimber L Osowski |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1982660908 PECOS PAC ID: 5294922563 Enrollment ID: I20240613003073 |
Provider Name | Elle White |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1376299636 PECOS PAC ID: 6901255280 Enrollment ID: I20240614001351 |