Organization · Type 2 NPI

Providence Health & Services - Washington

Family Medicine Physician · Palmer, AK

NPI number 1093720534 Active

Practice location

2250 S. Woodworth Loop, Suite 101
Palmer, AK 99645

Call (907) 761-5900 Map

Fax (907) 761-5975

Mailing address

PO Box 4105
Portland, OR 97208-4105

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Pediatrics Physician	208000000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Other family medicine physician providers in Palmer

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NPI record

NPI: 1093720534
Entity type: Organization (Type 2)
Issued: Jul 31, 2006
Last updated: May 15, 2025
Status: Active
Subpart: Yes of Providence Health and Services Alaska

Other names

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Providence Matanuska Health Care · doing business as

Authorized official

Donald Wayne Anderson
Assistant Secretary of Enrollments
(425) 358-9786

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 1093720534

Providence Health & Services - Washington's National Provider Identifier is 1093720534, issued on Jul 31, 2006. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Palmer, AK. The record was last updated on May 15, 2025.