Organization · Type 2 NPI

Providence Health & Services Washington

Emergency Medical Services (Emergency Medicine) Physician · Kodiak, AK

NPI number 1952430902 Active

Practice location

1915 E Rezanof Dr
Kodiak, AK 99615-6602

Call (907) 486-3281 Map

Mailing address

PO Box 3706
Portland, OR 97208-3706

Specialties and licenses

TaxonomyCodeLicense
Emergency Medical Services (Emergency Medicine) Physician Primary 207PE0004XNone listed
Hospitalist Physician 208M00000XNone listed
Critical Access Hospital 282NC0060X309115 (AK)

Emergency Medical Services (Emergency Medicine) Physician: An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.

35 other providers at this address

About NPI 1952430902

Providence Health & Services Washington's National Provider Identifier is 1952430902, issued on Mar 5, 2007. The primary taxonomy on file is Emergency Medical Services (Emergency Medicine) Physician (207PE0004X), and the practice location is in Kodiak, AK. The record was last updated on May 13, 2025.