Provider Demographics
NPI:1891188074
Name:ALASKA WEIGHT MANAGEMENT AND DIABETES COUNSELING
Entity Type:Organization
Organization Name:ALASKA WEIGHT MANAGEMENT AND DIABETES COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIGON
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:907-841-8978
Mailing Address - Street 1:2030 S KILLARNEY DR
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-8278
Mailing Address - Country:US
Mailing Address - Phone:907-841-8978
Mailing Address - Fax:
Practice Address - Street 1:642 S ALASKA ST
Practice Address - Street 2:SUITE #101
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6378
Practice Address - Country:US
Practice Address - Phone:907-707-1137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKDTN D 82133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty