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Organization

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Active
Other names
Providence In Home Services
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
4001 DALE ST, SUITE 101, ANCHORAGE, AK 99508-5428
(907) 212-4400
(907) 212-4401
Mailing address
3760 PIPER ST, SUITE 1061, ANCHORAGE, AK 99508-4665
(907) 212-0256
(907) 212-6547

Taxonomy

Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
251G00000X
Community Based Hospice Care Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1275869117
NPI
AK
05
HP6429
AK
Enumeration date
06/03/2006
Last updated
05/15/2025
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