NPI 1124355359

Shane Udelhoven, PAC

Practitioner Medical Physician Assistant Soldotna, AK

Practice location

Address: 35670 Kenai Spur Hwy STE 103a, Soldotna, AK 99669-7649
Phone: (907) 260-1655
Fax: (980) 495-8870
Mailing address: 48690 Tote Rd, Soldotna, AK 99669-9155

Registered specialties (2)

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence PADA893 (AK)

Other Physician Assistant providers in Alaska →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1124355359
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Nov 2009
Record last updated: 18 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.