Healthcare Provider Details

I. General information

NPI: 1952263444
Provider Name (Legal Business Name): SANTANNA SUMAUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 KATLIAN ST STE B
SITKA AK
99835-7359
US

IV. Provider business mailing address

700 KATLIAN ST STE B
SITKA AK
99835-7359
US

V. Phone/Fax

Practice location:
  • Phone: 907-747-6960
  • Fax: 907-276-6961
Mailing address:
  • Phone: 907-747-6960
  • Fax: 907-276-6961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number247684
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: