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PROVIDENCE HEALTH & SERVICES- WASHINGTON NPI 1093956278


NPI Information

NPI: 1093956278
Provider Name: PROVIDENCE HEALTH & SERVICES- WASHINGTON

Doing Business As: PROVIDENCE MEDICAL GROUP ALASKA

Classification: Internal Medicine - 207RC0200X
Entity Type: Organization

Specialization: Critical Care Medicine

Address:
3200 PROVIDENCE DR
ANCHORAGE, AK
ZIP 99508
Phone: (907) 212-6002
Get Directions

PROVIDENCE HEALTH & SERVICES- WASHINGTON is a critical care medicine internal medicine in Anchorage, AK. The provider is an internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. PROVIDENCE HEALTH & SERVICES- WASHINGTON NPI is 1093956278. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Providence Medical Group Alaska.

The provider's business location address is:

3200 PROVIDENCE DR
ANCHORAGE, AK
ZIP 99508-615
Phone: (907) 212-6002
Fax: (907) 212-8340

The provider's authorized official is Donald W Anderson .
The authorized official title is Asst Sec Enrollmt/dir Reimb Admin and has the following contact phone number (425) 525-5392.

The enumeration date for this NPI number is 3/17/2009 and was last updated on 3/7/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalNo
2207RC0200XInternal MedicineCritical Care MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11020543MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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