Healthcare Provider Details

I. General information

NPI: 1003742271
Provider Name (Legal Business Name): EILEEN MARIE CYR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

11921 E PALMER WASILLA HWY
PALMER AK
99645-8833
US

IV. Provider business mailing address

PO BOX 1907
PALMER AK
99645-1907
US

V. Phone/Fax

Practice location:
  • Phone: 360-544-9552
  • Fax: 360-249-7465
Mailing address:
  • Phone: 360-544-9552
  • Fax: 360-249-7465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: