OrganizationActive
Providence Health & Services Washington
NPI 1790889400 · Skilled Nursing Facility · Kodiak, AK
Provider details
- NPI number
- 1790889400
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary of Enrollments(425) 358-9786
- License
- 309115 (AK)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1915 E Rezanof Dr
Kodiak, AK 99615-6602
Phone: (907) 486-3281
Fax: (907) 486-9546
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 3706
Portland, OR 97208-3706
Other names (DBA / former)
- Doing business as
- Providence Kodiak Island Medical Center
- Doing business as
- Providence Kodiak Island Medical Center
Registry dates
- Enumerated
- 2006-09-12
- Last updated
- 2025-05-13
- Certified
- 2025-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.