Healthcare Provider Details

I. General information

NPI: 1306521315
Provider Name (Legal Business Name): ALASKA PSYCHIATRIC SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 GLACIER AVE STE 103
JUNEAU AK
99801-1567
US

IV. Provider business mailing address

1200 GLACIER AVE STE 103
JUNEAU AK
99801-1567
US

V. Phone/Fax

Practice location:
  • Phone: 907-600-1734
  • Fax: 907-600-1640
Mailing address:
  • Phone: 907-600-1734
  • Fax: 907-600-1640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. KATHY A GALLARDO
Title or Position: PSYCHIATRIST, SOLE PROPRIETOR
Credential: MD, PHD
Phone: 907-600-1734