Provider Demographics
NPI:1851919146
Name:ALASKA DIGESTIVE AND LIVER DISEASE, LLC
Entity Type:Organization
Organization Name:ALASKA DIGESTIVE AND LIVER DISEASE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:TYLOR
Authorized Official - Last Name:RYZNAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-569-1333
Mailing Address - Street 1:3851 PIPER ST STE U466
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-6905
Mailing Address - Country:US
Mailing Address - Phone:907-569-1333
Mailing Address - Fax:907-569-1433
Practice Address - Street 1:3851 PIPER ST STE U466
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-6905
Practice Address - Country:US
Practice Address - Phone:907-569-1333
Practice Address - Fax:907-569-1433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterologyGroup - Single Specialty
No163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Single Specialty
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty