PROVIDENCE HEALTH & SERVICES WASHINGTON
NPI 1790889400
Skilled Nursing Facility in Kodiak, AK

Active since September 12, 2006
1915 E REZANOF DR, KODIAK, AK 99615(907) 486-3281(907) 486-9546 Get Directions Write a Review

NPPES record last updated: May 13, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 13, 2025, Mar 1, 2022 (2 updates tracked since 2022).

About Providence Health & Services Washington NPPES

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

PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI 1790889400), doing business as Providence Kodiak Island Medical Center, is a healthcare organization registered as a skilled nursing facility in Kodiak, Alaska and active in the NPI registry since September 2006. The organization lists Donald Wayne Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1790889400
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePROVIDENCE HEALTH & SERVICES WASHINGTON
Location Address1915 E REZANOF DRKodiak, AK 99615-6602
Mailing AddressPo Box 3706Portland, OR 97208-3706 · (907) 486-3281 · Fax (907) 486-9546
Fax(907) 486-9546
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateSeptember 12, 2006
Last NPPES UpdateMay 13, 20252 updates tracked since enumeration
NPPES CertifiedMay 13, 2025
NPI 1790889400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in AK · 309115
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

1915 E REZANOF DR, Kodiak, AK 99615

Other Names 1

Doing Business AsProvidence Kodiak Island Medical Center

Other Identifiers 1

MedicaidHS10SBAK

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.

General Acute Care Hospital (Critical Access)
1915 E REZANOF DR
KODIAK, AK 99615
Surgery
1915 E REZANOF DR
KODIAK, AK 99615
Home Health
1915 E REZANOF DR
KODIAK, AK 99615
Clinic/Center (Radiology)
1915 E REZANOF DR
KODIAK, AK 99615
Pharmacy (Institutional Pharmacy)
1915 E REZANOF DR
KODIAK, AK 99615
Pharmacist
1915 E REZANOF DR
KODIAK, AK 99615
Pharmacist
1915 E REZANOF DR
KODIAK, AK 99615
Nurse Anesthetist, Certified Registered
1915 E REZANOF DR
KODIAK, AK 99615

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Health & Services Washington's NPI number?

The NPI number for Providence Health & Services Washington is 1790889400. It was assigned to this organization in the NPPES registry on September 12, 2006. The provider is doing business as Providence Kodiak Island Medical Center.

Where is Providence Health & Services Washington located?

Providence Health & Services Washington is located at 1915 E Rezanof Dr, Kodiak, AK 99615. The listed phone number is (907) 486-3281.

What is Providence Health & Services Washington's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Providence Health & Services Washington was last updated on May 13, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.