Healthcare Provider Details

I. General information

NPI: 1497105712
Provider Name (Legal Business Name): ARAWN BILLINGS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 12/02/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 WEST BLONDELL DRIVE
WASILLA AK
99623
US

IV. Provider business mailing address

1222 FREEMAN LN APT 5
POCATELLO ID
83201-2131
US

V. Phone/Fax

Practice location:
  • Phone: 907-357-9755
  • Fax:
Mailing address:
  • Phone: 801-380-7370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16371
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number16371
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number181928
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: