Healthcare Provider Details

I. General information

NPI: 1003403924
Provider Name (Legal Business Name): FORGET ME NOT OT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2020
Last Update Date: 08/10/2025
Certification Date: 08/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 W INTERNATIONAL AIRPORT RD STE A4
ANCHORAGE AK
99502-1119
US

IV. Provider business mailing address

2000 W INTERNATIONAL AIRPORT RD STE A4
ANCHORAGE AK
99502-1119
US

V. Phone/Fax

Practice location:
  • Phone: 907-317-5545
  • Fax: 907-865-2499
Mailing address:
  • Phone: 907-317-5545
  • Fax: 907-865-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY GERKEN
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: MT, OTR/L
Phone: 907-317-5545