Ketchikan Indian Corporation

NPI #1821120486 in Ketchikan, Alaska

Provider Information

NPI Number: 1821120486
Entity Type: Organization
Organization Name: Ketchikan Indian Corporation
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Mar 9, 2007
Last Updated: Apr 28, 2021

Practice Location

Address: 2960 TONGASS AVE
Address 2: BUSINESS OFFICE
City: Ketchikan
State: Alaska
ZIP Code: 99901-5742
Phone: (907) 228-9200

Authorized Official

Name: WENDY ROSS
Title: RCM
Phone: (907) 228-9254

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X
Community/Behavioral Health	251S00000X
Clinic/Center - Dental — Dental	261QD0000X
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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