Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Health & Services Washington

Organization Emergency Medical Services (Emergency Medicine) Physician · NPI 1952430902

Providence Health & Services Washington is an Emergency Medical Services (Emergency Medicine) Physician in Kodiak, Alaska. Licensed in Alaska. Registered with an NPI since 2007.

Licensed in
AK
In the registry since
2007
Specialties on file
3

Practice location Address checks out

1915 E Rezanof Dr
Kodiak, AK 99615-6602
Phone: (907) 486-3281
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medical Services (Emergency Medicine) Physician (primary) Taxonomy 207PE0004X
Hospitalist Physician Taxonomy 208M00000X
Critical Access Hospital Taxonomy 282NC0060X · Licence 309115 (AK)

Record details

NPI number1952430902
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Kodiak Island Medical Center; Providence Kodiak Island Medical Center
NPI enumeratedMarch 5, 2007
Last updated in NPPESMay 13, 2025
Certification dateMay 13, 2025
Mailing addressPo Box 3706, Portland, OR 97208-3706