Healthcare Provider Details

I. General information

NPI: 1033020045
Provider Name (Legal Business Name): ASHLEY PETERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 RAILWAY AVE
SEWARD AK
99664-0999
US

IV. Provider business mailing address

PO BOX 1045
SEWARD AK
99664-1045
US

V. Phone/Fax

Practice location:
  • Phone: 907-224-5257
  • Fax: 907-802-6310
Mailing address:
  • Phone: 907-224-5257
  • Fax: 907-802-6310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: