Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Other names
PROVIDENCE EXTENDED CARE CENTER
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
4900 EAGLE ST, ANCHORAGE, AK 99503-7446
(907) 562-2281
(907) 762-0266
Mailing address
PO BOX 196276, ANCHORAGE, AK 99519-6276
(907) 212-6522
(907) 212-6593
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NOT NUMBERED
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDG231
—
AK
Enumeration date
10/04/2006
Last updated
05/15/2025
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