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Organization

PROVIDENCE HEALTH & SERVICES WASHINGTON

Active
Other names
PROVIDENCE BREAKTHROUGH
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
3200 PROVIDENCE DR, ANCHORAGE, AK 99508-4615
(907) 212-6970
(907) 212-6971
Mailing address
PO BOX 4048, PORTLAND, OR 97208-4048

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
04/02/2020
Last updated
05/14/2025
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