Healthcare Provider Details

I. General information

NPI: 1982515862
Provider Name (Legal Business Name): YEPHETH YISRAEL LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 LAKE OTIS PKWY STE 100
ANCHORAGE AK
99507-1778
US

IV. Provider business mailing address

180 GRAND LARRY ST APT B2
ANCHORAGE AK
99504-5010
US

V. Phone/Fax

Practice location:
  • Phone: 907-277-3422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number256445
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: