Healthcare Provider Details

I. General information

NPI: 1922968296
Provider Name (Legal Business Name): SUSANNAH WESTHOFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSANNAH MAZER

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 3RD ST STE 200
FAIRBANKS AK
99701-3569
US

IV. Provider business mailing address

341 W TUDOR RD STE 209
ANCHORAGE AK
99503-6648
US

V. Phone/Fax

Practice location:
  • Phone: 907-416-2740
  • Fax: 907-931-7651
Mailing address:
  • Phone: 855-508-1075
  • Fax: 800-511-7484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: