Organization
SOUTHCENTRAL FOUNDATION
Active
Parent organization
SOUTHCENTRAL FOUNDATION
Other names
HPG- VNPCC Wellness Center (Valley Comp Med)
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHCENTRAL FOUNDATION
Authorized official
RONALD LEE OLSON (EXECUTIVE VICE PRESIDENT FINANCE)
(907) 729-4939
Entity
Organization
Contact information
Practice address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 631-7630
Mailing address
PO BOX 35198, SEATTLE, WA 98124-5198
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
133V00000X
Registered Dietitian
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1681496
—
AK
Enumeration date
01/30/2018
Last updated
09/14/2023
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