# PROVIDENCE HEALTH & SERVICES WASHINGTON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Home Health Alaska
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164532172
- **Authorized official:** MR. DONALD W ANDERSON JR. (DIR REIMB REG STRAT/ASST SEC ENROLL)
- **Authorized official phone:** (425) 525-5392

## Contact information

- **Practice address:** 4001 DALE ST, SUITE 101, ANCHORAGE, AK 99508-5428
- **Practice address phone:** (907) 563-0130
- **Practice address fax:** (907) 563-0135
- **Mailing address:** 4001 DALE ST STE 101, ANCHORAGE, AK 99508-5444
- **Mailing address phone:** (907) 563-0130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | AK | Yes |
| 251J00000X | Nursing Care Agency | — | AK | — |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 04/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | HH0174 | — | AK |
| 05 | — | NA1429 | — | AK |