Individual provider · Type 1 NPI

Crystal Lee Stordahl, PHYSICIAN ASSISTANT

Medical Physician Assistant · Fairbanks, AK

NPI number 1760505192 Active

Practice location

1408 19th Ave
Fairbanks, AK 99701-5903

Call (907) 452-8251 Map

Fax (907) 459-3978

Mailing address

201 1st Ave, Suite 300
Fairbanks, AK 99701-4848

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X518 (AK)

Medical Physician Assistant: Definition to come...

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About NPI 1760505192

Crystal Lee Stordahl, PHYSICIAN ASSISTANT's National Provider Identifier is 1760505192, issued on Apr 9, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Fairbanks, AK. The record was last updated on Jul 8, 2007.