Organization · Type 2 NPI

Southcentral Foundation

Community Health Clinic/Center · Iguigig, AK

NPI number 1144699216 Active

Practice location

4030 Salmon Way
Iguigig, AK 99613

Call (907) 533-3207 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 FoundationCommunity/Behavioral Health Agency Igiugig, AK NPI 1093318248
Southcentral FoundationGeneral Practice Dentistry Igiugig, AK NPI 1841747748

NPI record

NPI: 1144699216
Entity type: Organization (Type 2)
Issued: Sep 18, 2015
Last updated: Aug 31, 2023
Status: Active
Subpart: Yes of Southcentral Foundation

Other names

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

Authorized official

Ronald Lee Olson
Executive Vice President 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 1144699216

Southcentral Foundation's National Provider Identifier is 1144699216, issued on Sep 18, 2015. The primary taxonomy on file is Community Health Clinic/Center (261QC1500X), and the practice location is in Iguigig, AK. The record was last updated on Aug 31, 2023.