Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Parent organization
PROVIDENCE ALASKA MEDICAL CENTER
Other names
PROVIDENCE ALASKA MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE ALASKA MEDICAL CENTER
Authorized official
MR. DONALD ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
3200 PROVIDENCE DRIVE, ANCHORAGE, AK 99506-4615
(907) 212-6522
(907) 212-6593
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000ZBBBD
MEDICARE GROUP NUMBER
AK
01
—
02-0001
PTAN
AK
05
—
MDG798
—
AK
05
—
MDG7981
—
AK
05
—
MDG7982
—
AK
Enumeration date
10/04/2006
Last updated
05/14/2025
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