| Yakutat Community Health Center | |
|
115 Airport Rd Yakutat AK 99689 | |
| (907) 784-3275 | |
| (907) 784-3263 |
| Full Name | Yakutat Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 115 Airport Rd, Yakutat, Alaska |
| Authorized Official Name and Position | Cathy Wassillie (FINANCE MANAGER) |
| Authorized Official Contact | 9077843275 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yakutat Community Health Center Po Box 112 Yakutat AK 99689-0112 Ph: (907) 784-3275 | Yakutat Community Health Center 115 Airport Rd Yakutat AK 99689 Ph: (907) 784-3275 |
| NPI Number | 1871529628 |
|---|---|
| Provider Enumeration Date | 06/23/2006 |
| Last Update Date | 06/30/2021 |
| Medicare PECOS PAC ID | 7719894575 |
|---|---|
| Medicare Enrollment ID | O20080715000589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871529628 | NPI | - | NPPES |
| MEDICAID | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 288254 (Alaska) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Terri L Elliott |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1316932031 PECOS PAC ID: 8426952557 Enrollment ID: I20141219000329 |
| Provider Name | Ann Marie Licari Dryden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538239827 PECOS PAC ID: 9436230018 Enrollment ID: I20150113002260 |
| Provider Name | Debra S Scheel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568468189 PECOS PAC ID: 5496778391 Enrollment ID: I20161202000087 |
| Provider Name | Nolan Ellis Davis |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1013003268 PECOS PAC ID: 3173944113 Enrollment ID: I20200601000286 |
| Provider Name | Jessica Blanco |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1578995411 PECOS PAC ID: 2466874086 Enrollment ID: I20200626001071 |
Yakutat Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 712 Ocean Cape Road, Yakutat, AK 99689 Phone: 907-784-3275 Fax: 907-784-3263 | |
Yakutat Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 Airport Road, Yakutat, AK 99689 Phone: 907-784-3275 Fax: 907-784-3286 |