Healthcare Provider Details

I. General information

NPI: 1114402237
Provider Name (Legal Business Name): CLAUDINE IONA TUNGUL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1380 HINU PL APT C
PEARL CITY HI
96782-3002
US

IV. Provider business mailing address

3838 GALACTICA DR
ANCHORAGE AK
99517-1587
US

V. Phone/Fax

Practice location:
  • Phone: 907-726-7076
  • Fax:
Mailing address:
  • Phone: 907-726-7076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA-864-0
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: