Rainbow Medical Clinic
Organization Active NPI Physician Assistant · Big Lake, AK
NPI 1861637555 · NPPES record last updated Jul 23, 2009
Key facts
- NPI
- 1861637555
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 394 (AK)
- Legal business name
- RAINBOW MEDICAL CLINIC
- Practice address
- 10927 West Parks Hwy.
Big Lake, AK 99652-0562 - Phone
- (907) 892-3350
- Fax
- (907) 892-3351
- NPI assigned
- Dec 9, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Stephen Matthew Shortrige, PA-C
- Title
- Owner
- Phone
- (907) 892-3350
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant |
363A00000X | 394 | AK | Yes |
Addresses
Primary practice location
10927 West Parks Hwy.
Big Lake, AK 99652-0562
Mailing address
PO Box 520562
Big Lake, AK 99652-0562
Phone (907) 892-3350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700994118 | Other | NPI |
Other names
- Stephen Shortridge
Other providers in Big Lake, AK
- Lakeview Massage Therapy
- Jennifer Lloyd
- Margaret Maixner
- Renae Jean Nelson
- Brenda Kay Perkins
- Paul Allen Schranz
- Susan Olson DMD Inc
- Chrystle Williefay White
All providers in Big Lake, AK · Physician Assistant in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.