Organization
PROVIDENCE HEALTH & SERVICES- WASHINGTON
Active
Other names
PROVIDENCE MEDICAL GROUP ALASKA
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
3200 PROVIDENCE DR, ANCHORAGE, AK 99508-4615
(907) 212-6002
(907) 212-8340
Mailing address
PO BOX 31001-4162, PASADENA, CA 91110-4162
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020543
—
AK
Enumeration date
03/17/2009
Last updated
08/18/2025
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