Kevin James Clevenger
Community Health Worker in Ketchikan, AK. Individual provider (NPI-1).
NPI number1689475261
StatusActive
Last updated in NPPESMar 20, 2025
Details
- NPI
- 1689475261
- Entity type
- Individual (NPI-1)
- Name
- Kevin James Clevenger
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 20, 2025
- Certification date
- Mar 20, 2025
- Last updated
- Mar 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
313 Carlanna Lake RdKetchikan, AK 99901-5614
Phone 907-220-4846
Mailing address
721 Stedman StKetchikan, AK 99901-6632
Phone 907-225-7825
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All 48 Community Health Worker providers in Ketchikan · All 758 providers in Ketchikan
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