Healthcare Provider Details

I. General information

NPI: 1184350910
Provider Name (Legal Business Name): KARINA STARK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARINA RAUENHORST

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 E 36TH AVE
ANCHORAGE AK
99508-4372
US

IV. Provider business mailing address

PO BOX 4105
PORTLAND OR
97208-4105
US

V. Phone/Fax

Practice location:
  • Phone: 907-562-9229
  • Fax: 907-562-1603
Mailing address:
  • Phone: 866-907-1068
  • Fax: 425-917-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number227211
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number21336-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: