Organization · Type 2 NPI

Southcentral Foundation

Multi-Specialty Clinic/Center · Wasilla, AK

NPI number 1457196685 Active

Practice location

3505 E Meridian Park Loop Ste 220
Wasilla, AK 99654-7242

Call (907) 729-8901 Map

Mailing address

PO Box 35198
Seattle, WA 98124-5198

Other practice locations

4320 Diplomacy Dr Ste 2300, Anchorage, AK 99508-5925 · (907) 729-9989
1717 W Cowles St, Fairbanks, AK 99701-3975 · (907) 729-9989
1659 Cowles St, Ste 338, Fairbanks, AK 99701-5924 · (907) 729-8901

Specialties and licenses

Taxonomy	Code	License
Multi-Specialty Clinic/Center Primary	261QM1300X	None listed

Multi-Specialty Clinic/Center: Definition to come...

Other multi-specialty clinic/center providers in Wasilla

See all in Wasilla →

NPI record

NPI: 1457196685
Entity type: Organization (Type 2)
Issued: Jun 28, 2024
Last updated: Sep 9, 2025
Status: Active
Subpart: Yes of Southcentral Foundation

Other names

<unavail>
Alaska Subspecialty Pediatric Network (aspn) · doing business as
Alaska Subspecialty Pediatric Network (aspn) · doing business as

Authorized official

Ronald Lee Olson
Executive Vice President Finance
(701) 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.

Is this your record? How to update it.

About NPI 1457196685

Southcentral Foundation's National Provider Identifier is 1457196685, issued on Jun 28, 2024. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Wasilla, AK. The record was last updated on Sep 9, 2025.