Healthcare Provider Details

I. General information

NPI: 1265803761
Provider Name (Legal Business Name): ALANA BRANSON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2015
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3449 E REZANOF DR
KODIAK AK
99615-6952
US

IV. Provider business mailing address

1033 SW YAMHILL ST SUITE 403
PORTLAND OR
97205-2545
US

V. Phone/Fax

Practice location:
  • Phone: 907-486-9800
  • Fax:
Mailing address:
  • Phone: 503-309-4942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number3045
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number31553
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: