| Doctor Name: | MR. BRYAN ARTHUR SHORES |
| NPI Number: | 1417069162 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A., CDC-I |
| License Number: | |
| Business Practice Address: | 733 3rd Ferguson Building Kotzebue, AK - 99752 |
| Business Phone Number: | 9074427640 |
| Business Fax Number: | 9074427749 |
| Mailing Address: | 5808 Cordova St, Apt. #2 ANCHORAGE |
| State: | AK |
| Postal Code: | 995181355 |
| Phone Number: | 9075631000 |
| Fax Number: | |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 11/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |