PROVIDENCE HEALTH & SERVICES WASHINGTON NPI 1477563344

NPI Information

  • NPI: 1477563344
  • Provider Name: PROVIDENCE HEALTH & SERVICES WASHINGTON
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • :
  • Address: 1818 E REZANOF DR
    KODIAK, AK
    ZIP 99615
  • Phone: (907) 481-2400

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NPI Details

PROVIDENCE HEALTH & SERVICES WASHINGTON is a community behavioral health in Kodiak, AK. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. PROVIDENCE HEALTH & SERVICES WASHINGTON NPI is 1477563344. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

1818 E REZANOF DR
KODIAK, AK
ZIP 99615-505
Phone: (907) 481-2400
Fax: (907) 481-2419

The provider's authorized official is Donald Wayne Anderson .
The authorized official title is Assistant Secretary Of Enrollments and has the following contact phone number (425) 358-9786.

The enumeration date for this NPI number is 8/9/2006 and was last updated on 5/15/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinical297340ALASKANo
2171M00000XCase Manager/Care Coordinator297340ALASKANo
32084P0800XPsychiatry & NeurologyPsychiatry297340ALASKANo
4101YA0400XCounselorAddiction (Substance Use Disorder)297340ALASKANo
5251S00000XCommunity/Behavioral Health297340ALASKAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1MH 2237 & DA2237MEDICAIDALASKA

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: 11/21/2025

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