Provider Demographics
NPI:1922478940
Name:DUNCAN, FAYE C
Entity Type:Individual
Prefix:
First Name:FAYE
Middle Name:C
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALENDA
Other - Middle Name:FAYE
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33870 POLAR ST
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-9251
Mailing Address - Country:US
Mailing Address - Phone:907-987-8354
Mailing Address - Fax:
Practice Address - Street 1:33870 POLAR ST
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-9251
Practice Address - Country:US
Practice Address - Phone:907-987-8354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK200594225700000X
WAMA60598342225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist