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Organization
PROVIDENCE IMAGING CENTER
Active
Organization
PROVIDENCE IMAGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
3340 PROVIDENCE DR, ANCHORAGE, AK 99508
(907) 212-3151
(907) 212-5828
Mailing address
PO BOX 4567, PORTLAND, OR 97208-4567
(907) 212-3151
Taxonomy
Speciality
Code
Description
License number
State
261QR0207X
Mobile Mammography Clinic/Center
Primary
48375
AK
Other
Enumeration date
04/27/2017
Last updated
05/14/2025
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