Graduated: 2022
NPI: 1881335123
Practice Locations (2)
KODIAK ISLAND HEALTH CARE FOUNDATION
1911 E REZANOF DR
KODIAK, AK 996156602
9074815000
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1915 E REZANOF DR
KODIAK, AK 996156602
9074863281
Source: CMS National Downloadable File, September 2026.