PROVIDENCE HEALTH & SERVICES WASHINGTON
NPI 1629054374
General Acute Care Hospital - Critical Access in Kodiak, AK

Q: What is Providence Health & Services Washington's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital, specializing in Critical Access, with taxonomy code 282NC0060X.

Active since December 15, 2005

1915 E REZANOF DR, KODIAK, AK 99615(907) 486-9550 Get Directions Write a Review

NPPES record last updated: May 13, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2025, Dec 10, 2019 (2 updates tracked since 2019).

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About Providence Health & Services Washington NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI 1629054374), doing business as Providence Kodiak Island Medical Center Retail, is a healthcare organization registered as a critical access in Kodiak, Alaska and active in the NPI registry since December 2005. The organization lists Donald Wayne Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1629054374

Entity TypeOrganization

Primary Taxonomy282NC0060X

Legal Business NamePROVIDENCE HEALTH & SERVICES WASHINGTON

Location Address1915 E REZANOF DRKodiak, AK 99615-6602

Mailing AddressPo Box 3706Portland, OR 97208-3706 · (907) 486-9550 · Fax (907) 486-9553

Phone(907) 486-9550

Organization SubpartNo

Authorized OfficialDonald Wayne AndersonAssistant Secretary Of Enrollments · (425) 358-9786

Enumeration DateDecember 15, 2005

Last NPPES UpdateMay 13, 20252 updates tracked since enumeration

NPPES CertifiedMay 13, 2025

✔ NPI 1629054374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral Acute Care Hospital · Critical AccessHospitals

Taxonomy Code282NC0060X

License✔ Licensed in AK · 285

Also ListedPharmacy · Long Term Care PharmacyTaxonomy 3336L0003X

1915 E REZANOF DR, Kodiak, AK 99615

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Other Names 1

Doing Business AsProvidence Kodiak Island Medical Center Retail

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PROVIDENCE HEALTH & SERVICES WASHINGTON

General Acute Care Hospital (Critical Access)