Healthcare Provider Details

I. General information

NPI: 1457289621
Provider Name (Legal Business Name): ALYMPI MARTUSHEFF LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 S ALASKA ST STE 1A
PALMER AK
99645-6338
US

IV. Provider business mailing address

PO BOX 873936
WASILLA AK
99687-3936
US

V. Phone/Fax

Practice location:
  • Phone: 907-746-7836
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number211973
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: