Provider Demographics
NPI:1518576685
Name:ISAAC, SASHA ALENA DONENE
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:ALENA DONENE
Last Name:ISAAC
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 528
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:AK
Mailing Address - Zip Code:99559-0528
Mailing Address - Country:US
Mailing Address - Phone:907-543-6000
Mailing Address - Fax:
Practice Address - Street 1:290 HIGH SCHOOL LANE
Practice Address - Street 2:
Practice Address - City:SAINT MARY'S
Practice Address - State:AK
Practice Address - Zip Code:99658
Practice Address - Country:US
Practice Address - Phone:907-438-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator