Provider Demographics
NPI:1639421696
Name:TSINNIE, JUNIOR RAY
Entity Type:Individual
Prefix:MR
First Name:JUNIOR
Middle Name:RAY
Last Name:TSINNIE
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:PO BOX H
Mailing Address - Street 2:
Mailing Address - City:COPPER CENTER
Mailing Address - State:AK
Mailing Address - Zip Code:99573-0508
Mailing Address - Country:US
Mailing Address - Phone:907-822-5335
Mailing Address - Fax:907-822-5343
Practice Address - Street 1:MILE 2 TOK CUT-OFF
Practice Address - Street 2:
Practice Address - City:GAKONA
Practice Address - State:AK
Practice Address - Zip Code:99586
Practice Address - Country:US
Practice Address - Phone:907-822-5335
Practice Address - Fax:907-822-5343
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker