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Organization

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Active
Parent organization
PROVIDENCE HEALTH AND SERVICES ALASKA
Other names
Providence Matanuska Health Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROVIDENCE HEALTH AND SERVICES ALASKA
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization

Contact information

Practice address
2250 S. WOODWORTH LOOP, SUITE 101, PALMER, AK 99645
(907) 761-5900
(907) 761-5975
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
208000000X
Pediatrics Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MDG669
AK
Enumeration date
07/31/2006
Last updated
05/15/2025
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