Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Other names
PROVIDENCE MEDICAL GROUP ALASKA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
3760 PIPER ST, SUITE 1108, ANCHORAGE, AK 99508-4683
(907) 212-6900
(907) 212-6936
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020510
—
AK
05
—
1029396
—
AK
05
—
1595841
—
AK
05
—
1595851
—
AK
Enumeration date
10/04/2006
Last updated
05/14/2025
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