Provider Demographics
NPI:1679920896
Name:SANTILLANES, JULIANA (LMT)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:SANTILLANES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 PROVIDENCE DR
Mailing Address - Street 2:SUITE 425
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4661
Mailing Address - Country:US
Mailing Address - Phone:907-561-7111
Mailing Address - Fax:907-770-7891
Practice Address - Street 1:3260 PROVIDENCE DR
Practice Address - Street 2:SUITE 425
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4661
Practice Address - Country:US
Practice Address - Phone:907-561-7111
Practice Address - Fax:907-770-7891
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101541225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist