Provider Demographics
NPI:1225530850
Name:ACHAKENG, GABRIEL NTIMEH
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:NTIMEH
Last Name:ACHAKENG
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 1:2401 EAGLE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2197
Mailing Address - Country:US
Mailing Address - Phone:907-360-9496
Mailing Address - Fax:
Practice Address - Street 1:1840 BRAGAW ST STE 110
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3463
Practice Address - Country:US
Practice Address - Phone:907-562-4155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)