MEDICARE: SHAYLE LLIABAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1386572683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAYLE LLIABAN

Provider Business Mailing Address
First Line	:	7033 E TUDOR RD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-1262
Country	:	US
Telephone Number	:	907-729-8961
Fax Number	:	907-729-5180

Provider Business Practice Location Address
First Line	:	4341 TUDOR CENTRE DR STE 300
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5904
Country	:	US
Telephone Number	:	907-729-2500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

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Directions to “ SHAYLE LLIABAN ” Practice Location

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