| Eastern Aleutian Tribes, Inc | |
|
100 Slocum Drive King Cove AK 99612 | |
| (907) 497-2311 | |
| (907) 497-2310 |
| Full Name | Eastern Aleutian Tribes, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Slocum Drive, King Cove, Alaska |
| Authorized Official Name and Position | Jennifer Harrison (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9072771440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Aleutian Tribes, Inc 3380 C St Suite 100 Anchorage AK 99503-3920 Ph: (907) 277-1440 | Eastern Aleutian Tribes, Inc 100 Slocum Drive King Cove AK 99612 Ph: (907) 497-2311 |
| NPI Number | 1649332446 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 04/13/2015 |
| Medicare PECOS PAC ID | 2860301884 |
|---|---|
| Medicare Enrollment ID | O20180413000684 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649332446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (Alaska) | Primary |
| Provider Name | Patricia Delate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629081393 PECOS PAC ID: 7719920594 Enrollment ID: I20050602000621 |
| Provider Name | Dennis S Simpson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053347732 PECOS PAC ID: 4486675485 Enrollment ID: I20051216000612 |
| Provider Name | Robert C Trotter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952432569 PECOS PAC ID: 0749202224 Enrollment ID: I20051227000504 |
| Provider Name | Judy Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730162470 PECOS PAC ID: 1759323496 Enrollment ID: I20060509000235 |
| Provider Name | Michelle R Kaplan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417140393 PECOS PAC ID: 7113016809 Enrollment ID: I20080326001032 |
| Provider Name | Chadwick T Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821010109 PECOS PAC ID: 9638154164 Enrollment ID: I20100802000509 |
| Provider Name | Teresa Vial |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689921512 PECOS PAC ID: 7517114473 Enrollment ID: I20120828000492 |
| Provider Name | Keils K Kitchen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033350442 PECOS PAC ID: 8628120227 Enrollment ID: I20130530000177 |
| Provider Name | Shigone T Beighle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265838197 PECOS PAC ID: 5991026676 Enrollment ID: I20150605002291 |
| Provider Name | Dawn Lovisa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841212321 PECOS PAC ID: 3779776158 Enrollment ID: I20160316000197 |
| Provider Name | Molly Rothmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639238652 PECOS PAC ID: 0547458309 Enrollment ID: I20160421000227 |
| Provider Name | Jennifer Sanders |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578992434 PECOS PAC ID: 3779713292 Enrollment ID: I20161209001161 |
| Provider Name | Rebecca Sturdevant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396802112 PECOS PAC ID: 0143120402 Enrollment ID: I20170803002864 |
| Provider Name | Valerie Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720599723 PECOS PAC ID: 6406116052 Enrollment ID: I20180131000281 |
| Provider Name | Melissa N Cockrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093037731 PECOS PAC ID: 9830378306 Enrollment ID: I20180911003425 |
| Provider Name | Paul B Platz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194946707 PECOS PAC ID: 5395039721 Enrollment ID: I20181121002413 |
| Provider Name | Rachael Chapple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265903777 PECOS PAC ID: 5890035570 Enrollment ID: I20190315000184 |
| Provider Name | Colleen Slate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922246503 PECOS PAC ID: 0547317125 Enrollment ID: I20190826000564 |
| Provider Name | Kadijatu Kakay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992051270 PECOS PAC ID: 3274862479 Enrollment ID: I20190913001198 |
| Provider Name | Timothy Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134211568 PECOS PAC ID: 9739197567 Enrollment ID: I20200317000393 |
| Provider Name | Kevin M Iskra |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497060792 PECOS PAC ID: 4789015124 Enrollment ID: I20200519000881 |
| Provider Name | Matthew J Pitera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225097702 PECOS PAC ID: 9436111077 Enrollment ID: I20200702000180 |
| Provider Name | Elizabeth Rogers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588833453 PECOS PAC ID: 2163780057 Enrollment ID: I20201001000284 |
| Provider Name | Heather Nattkemper |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538581491 PECOS PAC ID: 6507082864 Enrollment ID: I20201118000032 |
| Provider Name | Kendell a Simm |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811936545 PECOS PAC ID: 0244228260 Enrollment ID: I20201209001260 |
| Provider Name | Kristen Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629679782 PECOS PAC ID: 6608275284 Enrollment ID: I20210602001245 |
| Provider Name | Torri Predmore |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649222985 PECOS PAC ID: 0840203618 Enrollment ID: I20210609000318 |
| Provider Name | Heather S Atamian |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427200302 PECOS PAC ID: 8022385632 Enrollment ID: I20210706000289 |
| Provider Name | Ryan Ashley Greene |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104231505 PECOS PAC ID: 2668691700 Enrollment ID: I20220321002468 |
| Provider Name | Rebekah Laupp |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972278729 PECOS PAC ID: 4183017205 Enrollment ID: I20220323001827 |
| Provider Name | Stephan Becker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063678795 PECOS PAC ID: 2062660921 Enrollment ID: I20220516000871 |
| Provider Name | Mitchell Forbes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578191003 PECOS PAC ID: 3072932367 Enrollment ID: I20221020000751 |
| Provider Name | Kele Ferreira |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083212625 PECOS PAC ID: 3072933621 Enrollment ID: I20221031002914 |
| Provider Name | Dallas M Thomason |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225361702 PECOS PAC ID: 2365577111 Enrollment ID: I20221208001404 |
| Provider Name | John P Davinson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962537019 PECOS PAC ID: 7517863996 Enrollment ID: I20221208002083 |
| Provider Name | Jillian Armele |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336898634 PECOS PAC ID: 5496123069 Enrollment ID: I20230222000196 |
| Provider Name | Justin M Dowd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316563927 PECOS PAC ID: 2264855840 Enrollment ID: I20230317000414 |
| Provider Name | Krista Rose |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679294698 PECOS PAC ID: 0143690958 Enrollment ID: I20230421001598 |
| Provider Name | Rachel Fortes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083852263 PECOS PAC ID: 3375609191 Enrollment ID: I20230424001109 |
| Provider Name | Karen Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306194576 PECOS PAC ID: 5890937726 Enrollment ID: I20230613001642 |
| Provider Name | Antonio Abreu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700246972 PECOS PAC ID: 6608122650 Enrollment ID: I20230614001876 |
| Provider Name | Dolores Van Bourgondien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457788390 PECOS PAC ID: 9032332275 Enrollment ID: I20231003000399 |
| Provider Name | Deborah L Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770908964 PECOS PAC ID: 2264663335 Enrollment ID: I20231128001233 |
| Provider Name | Jessica M Johnson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124540588 PECOS PAC ID: 4486926912 Enrollment ID: I20231212001612 |
| Provider Name | Loretta B Charles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912341306 PECOS PAC ID: 0446474811 Enrollment ID: I20231214000153 |
| Provider Name | Phillip R Hurd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194054312 PECOS PAC ID: 1759423312 Enrollment ID: I20240521001389 |
| Provider Name | Grant Robbins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053772392 PECOS PAC ID: 6608173331 Enrollment ID: I20240530002563 |
| Provider Name | Charles Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275065922 PECOS PAC ID: 8426461047 Enrollment ID: I20240531000412 |
| Provider Name | Bailey Alvarez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912444936 PECOS PAC ID: 0042642647 Enrollment ID: I20240606003908 |
| Provider Name | Gwen Cedfeldt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053947796 PECOS PAC ID: 0244689511 Enrollment ID: I20240613000902 |
| Provider Name | Jasmine Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508587411 PECOS PAC ID: 3274999321 Enrollment ID: I20240613001710 |
| Provider Name | Anne Chambers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427718428 PECOS PAC ID: 8022475193 Enrollment ID: I20240613002070 |
| Provider Name | Rebecca Ohlson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043793920 PECOS PAC ID: 6901263367 Enrollment ID: I20240613002815 |
| Provider Name | Kimber-lee Osowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982660908 PECOS PAC ID: 5294922563 Enrollment ID: I20240613003073 |
| Provider Name | Elle White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376299636 PECOS PAC ID: 6901255280 Enrollment ID: I20240614001351 |
| Provider Name | Kaylob M Candey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811588353 PECOS PAC ID: 4486018660 Enrollment ID: I20240627004116 |
| Provider Name | Christopher Polich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154318178 PECOS PAC ID: 3173538550 Enrollment ID: I20240731000846 |
| Provider Name | Amber Herbranson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851914006 PECOS PAC ID: 1254871130 Enrollment ID: I20240905003900 |
| Provider Name | Grace Capozzelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275203119 PECOS PAC ID: 0143769505 Enrollment ID: I20240905004047 |
| Provider Name | Jordyn Lindaman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528780350 PECOS PAC ID: 1658730270 Enrollment ID: I20240920001776 |
| Provider Name | Allicent Curry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629371745 PECOS PAC ID: 0244531853 Enrollment ID: I20240930003236 |
| Provider Name | Robert R Martin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568482297 PECOS PAC ID: 3577783059 Enrollment ID: I20241017004168 |
| Provider Name | Helene a Nau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811471758 PECOS PAC ID: 8729326616 Enrollment ID: I20241028002195 |
| Provider Name | Michelle Adler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902639438 PECOS PAC ID: 2062945645 Enrollment ID: I20241105000037 |
| Provider Name | Linda Boothe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912931502 PECOS PAC ID: 9931104304 Enrollment ID: I20241117000079 |
| Provider Name | Robert Salter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699789644 PECOS PAC ID: 4284758723 Enrollment ID: I20250103000705 |
| Provider Name | Rebecca O Palomar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811726946 PECOS PAC ID: 9234667007 Enrollment ID: I20250107001606 |
| Provider Name | Kathryn F Earle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144677535 PECOS PAC ID: 2860759040 Enrollment ID: I20250121000160 |
| Provider Name | Patrick Chaney |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801287776 PECOS PAC ID: 8820319973 Enrollment ID: I20250225003491 |
| Provider Name | Darlene Sanders |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164964672 PECOS PAC ID: 2769763176 Enrollment ID: I20250415000351 |
| Provider Name | Danielle Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750823084 PECOS PAC ID: 0244511137 Enrollment ID: I20250430003685 |
| Provider Name | Miles Ardaman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831142702 PECOS PAC ID: 1355364688 Enrollment ID: I20250716004075 |
| Provider Name | Jeremy Francis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992881338 PECOS PAC ID: 0749794428 Enrollment ID: I20250828000152 |
| Provider Name | Dennis Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508208976 PECOS PAC ID: 7416191119 Enrollment ID: I20251117002944 |
| Provider Name | Crystal Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730804857 PECOS PAC ID: 1557718111 Enrollment ID: I20251215000112 |
| Provider Name | Robert Fenton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730714486 PECOS PAC ID: 6002300225 Enrollment ID: I20251215001448 |
| Provider Name | Robert O Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669775771 PECOS PAC ID: 2264611045 Enrollment ID: I20251223000055 |
| Provider Name | Kassandra Placencio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629952858 PECOS PAC ID: 8729582762 Enrollment ID: I20260101000170 |
| Provider Name | Benjamin Ramos Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942184452 PECOS PAC ID: 8022500487 Enrollment ID: I20260203000359 |
| Provider Name | Haley Folta |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043802044 PECOS PAC ID: 0143614719 Enrollment ID: I20260603003060 |