Organization · Type 2 NPI

Southcentral Foundation

Community Health Clinic/Center · Kokhanok, AK

NPI number 1043689169 Active

Practice location

1008 Main Street
Kokhanok, AK 99606

Call (907) 282-2203 Map

Mailing address

PO Box 35198
Seattle, WA 98124-5198

Specialties and licenses

Taxonomy	Code	License
Community Health Clinic/Center Primary	261QC1500X	20467 (AK)

Community Health Clinic/Center: Definition to come...

2 other providers at this address

Southcentral FoundationGeneral Practice Dentistry Kokhanok, AK NPI 1497202394
Southcentral FoundationMental Health Clinic/Center (Including Community Mental Health Center) Kokhanok, AK NPI 1609235738

NPI record

NPI: 1043689169
Entity type: Organization (Type 2)
Issued: Sep 18, 2015
Last updated: Aug 30, 2023
Status: Active
Subpart: Yes of Southcentral Foundation

Other names

<unavail>
Tribal- Kokhanok Community Health Clinic · doing business as

Authorized official

Ronald Lee Olson
Executive Vice President of Finance
(907) 729-4939

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1043689169

Southcentral Foundation's National Provider Identifier is 1043689169, issued on Sep 18, 2015. The primary taxonomy on file is Community Health Clinic/Center (261QC1500X), and the practice location is in Kokhanok, AK. The record was last updated on Aug 30, 2023.