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Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Parent organization
PROVIDENCE HEALTH AND SERVICES ALASKA
Other names
Providence Matanuska Health Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH AND SERVICES ALASKA
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
2250 S. WOODWORTH LOOP, SUITE 101, PALMER, AK 99645
(907) 761-5900
(907) 761-5975
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDG669
—
AK
Enumeration date
07/31/2006
Last updated
05/15/2025
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