# PROVIDENCE MEDICAL CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1982957015
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 417 FIRST AVE, SEWARD, AK 99664-0365
- **Practice address phone:** (907) 224-5205
- **Mailing address:** PO BOX 430, SEWARD, AK 99664-0430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | 2310 | AK | Yes |

## Other

- **Enumeration date:** 10/26/2012
- **Last updated:** 05/12/2025