Healthcare Provider Details

I. General information

NPI: 1912039280
Provider Name (Legal Business Name): KATHY LYNNE TALLEY L.M.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 ARCTIC BLVD STE 102
ANCHORAGE AK
99503-4576
US

IV. Provider business mailing address

3310 ARCTIC BLVD STE 102
ANCHORAGE AK
99503-4576
US

V. Phone/Fax

Practice location:
  • Phone: 206-399-6370
  • Fax:
Mailing address:
  • Phone: 206-399-6370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number242911
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: