MEDICARE: AMERICA KOMAKHUK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		AK

General Provider Information

NPI Number	:	1972446383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMERICA KOMAKHUK

Provider Business Mailing Address
First Line	:	1530 CARA LOOP
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99515-3848
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1530 CARA LOOP
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99515-3848
Country	:	US
Telephone Number	:	907-360-5811
Fax Number	:	907-360-5811

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ AMERICA KOMAKHUK ” Practice Location

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