Healthcare Provider Details

I. General information

NPI: 1629100961
Provider Name (Legal Business Name): PLANNED PARERTHOOD OF ALASKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 LAKE OTIS PKWY
ANCHORAGE AK
99508-5211
US

IV. Provider business mailing address

514 LAKE ST SUITE B
SITKA AK
99835-7403
US

V. Phone/Fax

Practice location:
  • Phone: 907-565-7526
  • Fax: 907-565-7529
Mailing address:
  • Phone: 907-747-3883
  • Fax: 907-747-8282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number125738
License Number StateAK

VIII. Authorized Official

Name: MS. CLOVER SIMON
Title or Position: CEO
Credential:
Phone: 907-770-9705