Provider Demographics
NPI:1487077137
Name:VASKA, ESTHER
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:VASKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:AGWIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:RUSSIAN MISSION
Mailing Address - State:AK
Mailing Address - Zip Code:99657
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 MAIN ROAD
Practice Address - Street 2:
Practice Address - City:RUSSIAN MISSION
Practice Address - State:AK
Practice Address - Zip Code:99657
Practice Address - Country:US
Practice Address - Phone:907-584-5611
Practice Address - Fax:907-584-5830
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker