Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
PROVIDENCE KODIAK ISLAND COUNSELING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1818 E REZANOF DR, KODIAK, AK 99615-6505
(907) 481-2400
(907) 481-2419
Mailing address
PO BOX 31001-4162, PASADENA, CA 91110-4162
(907) 486-9500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
297340
AK
1041C0700X
Clinical Social Worker
297340
AK
171M00000X
Case Manager/Care Coordinator
297340
AK
2084P0800X
Psychiatry Physician
297340
AK
251S00000X
Community/Behavioral Health Agency
Primary
297340
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH 2237 & DA2237
—
AK
Enumeration date
08/09/2006
Last updated
06/30/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up