Healthcare Provider Details

I. General information

NPI: 1770108292
Provider Name (Legal Business Name): CHRISTOPHER EARL GUNDERSON RN, LPC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 W NORTHERN LIGHTS BLVD
ANCHORAGE AK
99503-2503
US

IV. Provider business mailing address

3705 ARCTIC BLVD # 364
ANCHORAGE AK
99503-5774
US

V. Phone/Fax

Practice location:
  • Phone: 907-980-7035
  • Fax:
Mailing address:
  • Phone: 907-980-7035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number260638
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number223789
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number107793
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: