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LEGACY HEALTH CLINIC, LLC
NPI 1942670005
Nurse Practitioner - Adult Health in Ketchikan, AK

Active since October 01, 2015CLIA 02D2103660 · Waiver
3524 TONGASS AVE, KETCHIKAN, AK 99901(907) 225-6355 Get Directions Write a Review

NPPES record last updated: October 1, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Legacy Health Clinic, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY HEALTH CLINIC, LLC (NPI 1942670005) is a healthcare organization registered as an adult health in Ketchikan, Alaska and active in the NPI registry since October 2015. The organization holds a CLIA Waiver certificate valid through October 15, 2027 and lists Helen R Klein, Owner, as its authorized official.

NPPES Registry Identity

NPI1942670005
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NameLEGACY HEALTH CLINIC, LLC
Location Address3524 TONGASS AVEKetchikan, AK 99901-5635
Mailing Address3524 Tongass AveKetchikan, AK 99901-5635 · (907) 225-6355
Phone(907) 225-6355
Organization SubpartNo
Authorized OfficialHelen R KleinOwner · (907) 225-6355
Enumeration DateOctober 1, 2015
✔ NPI 1942670005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in AK · 1106
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 551 (AK)
3524 TONGASS AVE, Ketchikan, AK 99901
Open in Google Maps ↗

Other Identifiers 4

Medicaid1580081AK
Medicare PINK164537AK
Medicaid1022301AK
Medicare PINK162622AK

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 02D2103660

Legacy Health Clinic, LLC · Ketchikan, AK
Active · expires Oct 15, 2027
CLIA Number02D2103660
Laboratory TypePractitioner Other
Certificate Effective DateOctober 16, 2025
Certificate Expiration DateOctober 15, 2027
Laboratory DirectorHelen R. Klein
Laboratory Phone(907) 225-6355
Laboratory LocationLegacy Health Clinic, LLC3524 Tongass Avenue, Ketchikan, AK 99901
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. HELEN ROSE KLEIN NURSE PRACTITIONER
Nurse Practitioner (Family)
3524 TONGASS AVE
KETCHIKAN, AK 99901
Ketchikan Gateway Borough (907) 225-9830
JESSICA RAE PILCHER NP
Nurse Practitioner (Adult Health)
3524 TONGASS AVE
KETCHIKAN, AK 99901
Ketchikan Gateway Borough (907) 225-9830
SARAH ELIZABETH BASS FNP-C
Nurse Practitioner (Family)
3524 TONGASS AVE
KETCHIKAN, AK 99901
Ketchikan Gateway Borough (907) 225-6355

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Health Clinic, LLC's NPI number?

The NPI number for Legacy Health Clinic, LLC is 1942670005. It was assigned to this organization in the NPPES registry on October 1, 2015.

Where is Legacy Health Clinic, LLC located?

Legacy Health Clinic, LLC is located at 3524 Tongass Ave, Ketchikan, AK 99901. The listed phone number is (907) 225-6355.

What is Legacy Health Clinic, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Does Legacy Health Clinic, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 02D2103660) is associated with this NPI, valid through October 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Legacy Health Clinic, LLC was last updated on October 1, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.