SHASTA PETERSEN

ANCHORAGE, AK
NPI1841742616
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
Enumeration Date2016-10-27
Last Update Date2016-10-27
Business Address
-- SHASTA PETERSEN LMT
2091 WALDRON DR
ANCHORAGE, AK 99507-1343
Phone number: 208-244-2962
Mailing Address
-- SHASTA PETERSEN LMT
PO BOX 231332
ANCHORAGE, AK 99523-1332
Phone number: 208-604-4263