Providence Health & Services Washington
May also be knows as Providence Kodiak Island Counseling Center
Community/Behavioral Health Agency in Kodiak, AK(View on Map)
Legal Business Name
Providence Health & Services Washington
Also Known As
Providence Kodiak Island Counseling Center
NPI Number
1477563344
NPI Type
Organization
Enumeration Date
08/09/2006
Specialties
(Taxonomies)Name
Code
251S00000X
101YA0400X
171M00000X
1041C0700X
2084P0800X
Primary Taxonomy
Yes
No
No
No
No
Licenses
State
Alaska
License Number
297340
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 3290
1818 E REZANOF DR
City
Portland
Kodiak
State
OR
AK
Postal Code
97208-3290
99615-6505
Country
US
US
Telephone Number
(907) 486-9500
(907) 481-2400
Authorized Official
Name
Mr. Donald Anderson
Title or Position
ASSISTANT SECRETARY OF ENROLLMENTS
Telephone Number
(425) 525-5392
Identifiers
Identifier
MH 2237 & DA2237
Identifier State
AK
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 05/23/2024
Provider Address
Other Community/Behavioral Health Agencies in Kodiak, Alaska:
Providence Kodiak Island Counseling Center
Kodiak, AKSpecialty: Community/Behavioral Health Agency (Primary)
Community Inclusion Services
Kodiak, AKSpecialties: Community/Behavioral Health Agency (Primary)Case Management AgencyIn Home Supportive Care AgencySupports Brokerage AgencyVoluntary or Charitable Agency