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Organization
PKIMC HOME HEALTH
Active
Organization
PKIMC HOME HEALTH
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
1915 E REZANOF DR, KODIAK, AK 99615-6602
(907) 481-2490
(907) 481-2497
Mailing address
PO BOX 3706, PORTLAND, OR 97208-3706
(907) 481-2490
(907) 481-2497
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
16608
AK
Other
Enumeration date
12/27/2007
Last updated
05/13/2025
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