Provider Demographics
NPI:1437380391
Name:CHRISTMAS, JAMES L III (BA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:CHRISTMAS
Suffix:III
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 SAN JERONIMO DR # 210
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2870
Mailing Address - Country:US
Mailing Address - Phone:907-793-3200
Mailing Address - Fax:907-793-3250
Practice Address - Street 1:3600 SAN JERONIMO DR STE 210
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2870
Practice Address - Country:US
Practice Address - Phone:907-793-3200
Practice Address - Fax:907-793-3250
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMH9780Medicaid