Organization
PROVIDENCE HEALTH & SERVICES-WASHINGTON
Active
Organization
PROVIDENCE HEALTH & SERVICES-WASHINGTON
Active
Other names
PROVIDENCE MEDICAL GROUP ALASKA
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
3200 PROVIDENCE DR, ANCHORAGE, AK 99508-4615
(907) 212-6002
(907) 212-8340
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/05/2020
Last updated
07/10/2025
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