Healthcare Provider Details

I. General information

NPI: 1932025996
Provider Name (Legal Business Name): JUNLIN FANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 W NORTHERN LIGHTS BLVD STE C
ANCHORAGE AK
99503-3614
US

IV. Provider business mailing address

3108 W 35TH AVE UNIT B
ANCHORAGE AK
99517-2241
US

V. Phone/Fax

Practice location:
  • Phone: 907-334-8020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number251028
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: