Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Other names
Providence Lifeline
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
4001 DALE ST, SUITE 101, ANCHORAGE, AK 99508-5428
(907) 563-0130
(907) 563-0135
Mailing address
4001 DALE ST, SUITE 101, ANCHORAGE, AK 99508-5428
(907) 563-0130
(907) 563-0135
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MS0012
—
AK
Enumeration date
04/24/2007
Last updated
05/15/2025
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