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1023222783
IDA SHANNON CHARLIE
BETHEL, AK
NPI
1023222783
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2007-05-10
Last Update Date
2022-07-21
Business Address
IDA SHANNON CHARLIE
829 CHIEF EDDIE HOFFMAN HWY SUITE 150
BETHEL, AK 99559
Phone number: 907-543-6100
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Mailing Address
IDA SHANNON CHARLIE
P.O. BOX 528 ATTN: BH VILLAGE SERVICES
BETHEL, AK 99559
Phone number: 907-543-6100
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