| Dahl Memorial Clinic | |
|
350 14th Avenue Skagway AK 99840 | |
| (907) 983-2255 | |
| (907) 983-2793 |
| Full Name | Dahl Memorial Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 350 14th Avenue, Skagway, Alaska |
| Authorized Official Name and Position | Albert Wall (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9079832255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dahl Memorial Clinic Po Box 537 Skagway AK 99840-0537 Ph: (907) 983-2255 | Dahl Memorial Clinic 350 14th Avenue Skagway AK 99840 Ph: (907) 983-2255 |
| NPI Number | 1063574200 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 07/19/2025 |
| Certification Date | 07/19/2025 |
| Medicare PECOS PAC ID | 0244227726 |
|---|---|
| Medicare Enrollment ID | O20040427001153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063574200 | NPI | - | NPPES |
| 1029911 | Medicaid | AK | |
| 153026 | Other | AK | MEDICARE PART B |
| 021836 | Other | AK | MEDICARE FQHC |
| Provider Name | Ann Ehret |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386672400 PECOS PAC ID: 3476649740 Enrollment ID: I20071017000842 |
| Provider Name | Keils K Kitchen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033350442 PECOS PAC ID: 8628120227 Enrollment ID: I20091124000394 |
| Provider Name | Marjorie Ackerman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770974008 PECOS PAC ID: 1557688694 Enrollment ID: I20150328000330 |
| Provider Name | William Weiss |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346372620 PECOS PAC ID: 5294055646 Enrollment ID: I20150526001951 |
| Provider Name | Nicholas Newbury |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417214933 PECOS PAC ID: 1153611058 Enrollment ID: I20160606001573 |
| Provider Name | Karen Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306194576 PECOS PAC ID: 5890937726 Enrollment ID: I20190408002452 |
| Provider Name | Dolores Van Bourgondien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457788390 PECOS PAC ID: 9032332275 Enrollment ID: I20190610000219 |
| Provider Name | Timothy Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134211568 PECOS PAC ID: 9739197567 Enrollment ID: I20191003002801 |
| Provider Name | David Bartal |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366529919 PECOS PAC ID: 0648442681 Enrollment ID: I20191209001783 |
| Provider Name | Nicholas Rosenfeld |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750701793 PECOS PAC ID: 0547487712 Enrollment ID: I20200116002358 |
| Provider Name | Thomas H Wendel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790720258 PECOS PAC ID: 0345240255 Enrollment ID: I20200416003489 |
| Provider Name | Mark Roman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588692602 PECOS PAC ID: 6305866054 Enrollment ID: I20200612002311 |
| Provider Name | Elizabeth Rogers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588833453 PECOS PAC ID: 2163780057 Enrollment ID: I20200930002299 |
| Provider Name | Brent Kunzler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699947192 PECOS PAC ID: 7012080237 Enrollment ID: I20220105001997 |
| Provider Name | Rebekah Laupp |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972278729 PECOS PAC ID: 4183017205 Enrollment ID: I20220222001306 |
| Provider Name | Kathleen Rooney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932351871 PECOS PAC ID: 3173686094 Enrollment ID: I20220412002785 |
| Provider Name | Stephan Becker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063678795 PECOS PAC ID: 2062660921 Enrollment ID: I20220509002364 |
| Provider Name | Tracey L Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306247796 PECOS PAC ID: 4284926254 Enrollment ID: I20220817000613 |
| Provider Name | Michelle J Hinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346717428 PECOS PAC ID: 2466794961 Enrollment ID: I20220823002386 |
| Provider Name | Mitchell Forbes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578191003 PECOS PAC ID: 3072932367 Enrollment ID: I20221010000583 |
| Provider Name | Valerie Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720599723 PECOS PAC ID: 6406116052 Enrollment ID: I20221019003262 |
| Provider Name | Kele Ferreira |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083212625 PECOS PAC ID: 3072933621 Enrollment ID: I20221025002685 |
| Provider Name | Brittany Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871851022 PECOS PAC ID: 5799948873 Enrollment ID: I20230109001183 |
| Provider Name | Jillian Armele |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336898634 PECOS PAC ID: 5496123069 Enrollment ID: I20230216002137 |
| Provider Name | Laura Brewer James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972881175 PECOS PAC ID: 5193983427 Enrollment ID: I20230510002713 |
| Provider Name | Jason B Deluisa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629200894 PECOS PAC ID: 4486791548 Enrollment ID: I20230712001972 |
| Provider Name | Mira Scharff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821696519 PECOS PAC ID: 7719348952 Enrollment ID: I20230803002023 |
| Provider Name | Bartlett Davis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205058948 PECOS PAC ID: 2961594940 Enrollment ID: I20230915003226 |
| Provider Name | Conor Daniel Cahalan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588273338 PECOS PAC ID: 1557786340 Enrollment ID: I20231016003072 |
| Provider Name | Kira Kristina Lathrop |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609223809 PECOS PAC ID: 4880042704 Enrollment ID: I20231201002486 |
| Provider Name | Jodi Bauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376889279 PECOS PAC ID: 9830336619 Enrollment ID: I20240108006232 |
| Provider Name | Nicolette Broby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235641382 PECOS PAC ID: 0345500674 Enrollment ID: I20240131005123 |
| Provider Name | Daniel Deublein |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053625558 PECOS PAC ID: 6406040112 Enrollment ID: I20240209001909 |
| Provider Name | Lindsey Marie Johanning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649055195 PECOS PAC ID: 5395192314 Enrollment ID: I20240212002857 |
| Provider Name | Colleen Slate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922246503 PECOS PAC ID: 0547317125 Enrollment ID: I20240221003910 |
| Provider Name | Adam T Richins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023381860 PECOS PAC ID: 8426217001 Enrollment ID: I20240307000635 |
| Provider Name | Samuel Simmons |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619305828 PECOS PAC ID: 3476780800 Enrollment ID: I20240307003692 |
| Provider Name | Casey Hill |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336723469 PECOS PAC ID: 2668862962 Enrollment ID: I20240507002867 |
| Provider Name | Tammy Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497783146 PECOS PAC ID: 6406742659 Enrollment ID: I20240528003498 |
| Provider Name | Narda Sherman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922192764 PECOS PAC ID: 7416980313 Enrollment ID: I20240610001594 |
| Provider Name | Diane L Roche |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952840647 PECOS PAC ID: 1254697139 Enrollment ID: I20240812002792 |
| Provider Name | Aaron Jakob Wiger |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649807041 PECOS PAC ID: 3678987559 Enrollment ID: I20241127000826 |
| Provider Name | Leslie J Ballard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922069335 PECOS PAC ID: 5890693691 Enrollment ID: I20250509001586 |
| Provider Name | Adriana Aleixo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457806424 PECOS PAC ID: 8628094463 Enrollment ID: I20250611001473 |
| Provider Name | Christopher Robertson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407189145 PECOS PAC ID: 4587686951 Enrollment ID: I20250613003421 |
| Provider Name | Jeremy Francis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992881338 PECOS PAC ID: 0749794428 Enrollment ID: I20250725003203 |
| Provider Name | Stacy Bernadetta Toner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699666727 PECOS PAC ID: 3476051889 Enrollment ID: I20250813003145 |
| Provider Name | Miles Ardaman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831142702 PECOS PAC ID: 1355364688 Enrollment ID: I20250822002791 |
| Provider Name | Kristy Bryant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053642439 PECOS PAC ID: 6002947363 Enrollment ID: I20251210004334 |
| Provider Name | Claire Louise Ramos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114518347 PECOS PAC ID: 5799264941 Enrollment ID: I20260208000233 |
Dahl Memorial Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 350 14th Ave, Skagway, AK 99840 Phone: 907-983-2255 Fax: 907-983-2739 |