Provider Demographics
NPI:1790030088
Name:ADAMSON, JENNIFER K
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:K
Last Name:ADAMSON
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 1:5636 GLACIER HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9508
Mailing Address - Country:US
Mailing Address - Phone:907-586-6838
Mailing Address - Fax:907-586-8114
Practice Address - Street 1:5636 GLACIER HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9508
Practice Address - Country:US
Practice Address - Phone:907-586-6838
Practice Address - Fax:907-586-8114
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator