Healthcare Provider Details

I. General information

NPI: 1184400293
Provider Name (Legal Business Name): ANCHORAGE RADIATION THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 11/30/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2841 DEBARR RD STE 100
ANCHORAGE AK
99508-2945
US

IV. Provider business mailing address

PO BOX 84472
SEATTLE WA
98124-5772
US

V. Phone/Fax

Practice location:
  • Phone: 907-276-2400
  • Fax: 907-276-4888
Mailing address:
  • Phone: 907-276-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0203X
TaxonomyRadiation Oncology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASHLYN KRAUSE
Title or Position: PRACTICE MANAGER
Credential:
Phone: 907-276-2400