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1417553934
RUSSELL PAGE
KETCHIKAN, AK
NPI
1417553934
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2020-12-09
Last Update Date
2021-02-09
Business Address
RUSSELL PAGE
2438 THIRD AVE
KETCHIKAN, AK 99901-5814
Phone number: 907-225-7825
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Mailing Address
RUSSELL PAGE
721 STEDMAN ST
KETCHIKAN, AK 99901-6632
Phone number: 907-225-7825
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