Provider Demographics
NPI:1720424575
Name:GACH, GATWECH JARL
Entity Type:Individual
Prefix:
First Name:GATWECH
Middle Name:JARL
Last Name:GACH
Suffix:
Gender:M
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 110554
Mailing Address - Street 2:ANCHORAGE
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99511-0554
Mailing Address - Country:US
Mailing Address - Phone:907-227-7081
Mailing Address - Fax:
Practice Address - Street 1:7821 ISLAND DR
Practice Address - Street 2:ANCHORAGE
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2728
Practice Address - Country:US
Practice Address - Phone:907-227-7081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider