Provider Demographics
NPI:1073012753
Name:PASI, JEREMIAH SAPATI
Entity Type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:SAPATI
Last Name:PASI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3722 PARSONS AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-1216
Mailing Address - Country:US
Mailing Address - Phone:907-258-1141
Mailing Address - Fax:907-258-1527
Practice Address - Street 1:3722 PARSONS AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-1216
Practice Address - Country:US
Practice Address - Phone:907-258-1141
Practice Address - Fax:907-258-1527
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK7344226OtherDRIVING LICENSE