Healthcare Provider Details

I. General information

NPI: 1417022963
Provider Name (Legal Business Name): ANALISA SELDEN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44539 STERLING HWY SUITE 206
SOLDOTNA AK
99669-7938
US

IV. Provider business mailing address

246 RIVER WATCH DR
SOLDOTNA AK
99669-7354
US

V. Phone/Fax

Practice location:
  • Phone: 907-260-9400
  • Fax: 907-262-9422
Mailing address:
  • Phone: 907-260-4827
  • Fax: 907-262-9422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: