Ida Shannon Charlie

NPI #1023222783 in Bethel, Alaska

Provider Information

NPI Number: 1023222783
Entity Type: Individual
Name: Ida Shannon Charlie
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Community Health Worker
Enumeration Date: May 10, 2007
Last Updated: Jul 21, 2022

Practice Location

Address: 829 CHIEF EDDIE HOFFMAN HWY
Address 2: SUITE 150
City: Bethel
State: Alaska
ZIP Code: 99559
Phone: (907) 543-6100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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