# PKIMC HOME HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477737393
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 1915 E REZANOF DR, KODIAK, AK 99615-6602
- **Practice address phone:** (907) 481-2490
- **Practice address fax:** (907) 481-2497
- **Mailing address:** PO BOX 3706, PORTLAND, OR 97208-3706
- **Mailing address phone:** (907) 481-2490
- **Mailing address fax:** (907) 481-2497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 16608 | AK | Yes |

## Other

- **Enumeration date:** 12/27/2007
- **Last updated:** 05/13/2025