Provider Demographics
NPI:1639629066
Name:UNGWILUK, YUKA
Entity Type:Individual
Prefix:
First Name:YUKA
Middle Name:
Last Name:UNGWILUK
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 155
Mailing Address - Street 2:
Mailing Address - City:GAMBELL
Mailing Address - State:AK
Mailing Address - Zip Code:99742-0155
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:189 GRAVEL ROAD
Practice Address - Street 2:
Practice Address - City:GAMBELL
Practice Address - State:AK
Practice Address - Zip Code:99742
Practice Address - Country:US
Practice Address - Phone:907-985-5443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor