Haakan Bohman, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

202724 Issued in AK

Practice address

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083

Phone

(907) 631-7630

Fax

(907) 729-5180

NPI assigned

Jan 17, 2025

Last updated

Jan 17, 2025By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1528879574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262",
            "telephone_number": "907-729-3300",
            "fax_number": "907-729-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S KNIK GOOSE BAY RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548083",
            "telephone_number": "907-631-7630",
            "fax_number": "907-729-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHMAN",
        "first_name": "HAAKAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AK",
            "license": "202724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Physical Therapy Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.