Provider Demographics
NPI:1184008302
Name:TOWARAK, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:TOWARAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:270 MAIN STREET
Mailing Address - City:UNALAKLEET
Mailing Address - State:AK
Mailing Address - Zip Code:99684-0270
Mailing Address - Country:US
Mailing Address - Phone:907-624-3622
Mailing Address - Fax:907-624-3619
Practice Address - Street 1:270 MAIN STREET
Practice Address - Street 2:
Practice Address - City:UNALAKLEET
Practice Address - State:AK
Practice Address - Zip Code:99684-0270
Practice Address - Country:US
Practice Address - Phone:907-624-3622
Practice Address - Fax:907-624-3619
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK068OtherCARE COORDINATOR CERTIFICATION