PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1396096996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396096996 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Other Organization Name | PROVIDENCE EXTENDED CARE |
| Practice Address |
3760 Piper St Suite 1061 Anchorage AK 99508-4683 |
| Mailing Address |
920 Compassion Circle Anchorage AK 99504 |
| Practice Telephone | 9072120256 |
| Practice Fax Number | 9072126547 |
| Mailing Telephone | 9072129200 |
| Mailing Fax Number | 9072129280 |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2014-08-08 |
| Authorized Official Name | TODD HOFHEINS (VP CFO) |
| Authorized Official Telephone | 4255253355 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 1615041 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Extended Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407162571 | Providence Health & Services - Washington | Internal Medicine | 510 E Amende Drive, Odessa, WA 99159-0000 | 2010-08-26 |
| 1841503034 | Providence Health & Services - Washington | Family Medicine | 18313 Paulsonst Sw, Suite A, Rochester, WA 98579-9262 | 2010-07-16 |
| 1083947709 | Providence Health & Services - Washington | Hospice Care, Community Based | 2731 Wetmore Ave Ste 500, Everett, WA 98201-3585 | 2009-09-14 |
| 1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
| 1558512368 | Providence Health & Services - Washington | Home Health | 209 W Poplar St, Walla Walla, WA 99362 | 2008-10-10 |
| 1922259738 | Providence Health & Services - Washington | Internal Medicine | 380 Chase Avenue, Pmg Se Wa, Walla Walla, WA 99362-2924 | 2008-10-10 |
| 1306097126 | Providence Health & Services - Washington | Radiology | 401 W Poplar Street, Pmg Se Wa Imaging, Walla Walla, WA 99362-2846 | 2008-10-10 |
| 1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
| 1073677605 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 506 W Franklin St, Shelton, WA 98584-3517 | 2006-12-20 |
| 1003906918 | Providence Health & Services - Washington | Home Health | 3432 Bay Rd Ne, Olympia, WA 98506-2958 | 2006-10-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
3760 PIPER ST SUITE 1061 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-4683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306811484 | Donna Yvette Westlake | Psychiatry & Neurology | 3760 Piper St, Suite 1108, Anchorage, AK 99508-4683 | 2006-02-21 |
| 1447707211 | Kathleen Walgren | Counselor | 3760 Piper St, Suite Ll139, Anchorage, AK 99508-4683 | 2016-09-08 |
| 1881141232 | Faren Kirkland | Registered Nurse | 3760 Piper St, Suite Ll139, Anchorage, AK 99508-4683 | 2016-09-01 |
| 1386093839 | Colleen Rose Johnson | Counselor | 3760 Piper St, Suite Ll139, Anchorage, AK 99508-4683 | 2016-06-06 |
| 1639537947 | Renee Rafferty | Counselor | 3760 Piper St, Suite 1108, Anchorage, AK 99508-4683 | 2016-02-01 |
| 1447620208 | Ashley C Martin | Counselor | 3760 Piper St, Anchorage, AK 99508-4683 | 2015-10-05 |
| 1407244486 | Wendy Sprague | Counselor | 3760 Piper St, Suite 1108, Anchorage, AK 99508-4683 | 2014-12-29 |
| 1801292156 | Holley Ryan | Counselor | 3760 Piper St, Suite Ll139, Anchorage, AK 99508-4683 | 2014-11-14 |
| 1780080408 | Lisa A Pierce | Social Worker | 3760 Piper St, Suite Ll139, Anchorage, AK 99508-4683 | 2014-11-06 |
| 1497151294 | Jennifer K Hawkins | Registered Nurse | 3760 Piper St, Suite Ll139, Anchorage, AK 99508-4683 | 2014-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780866715 | Raindance Healthcare Group, Inc. | Skilled Nursing Facility | 3510 Spenard Rd Ste 100, Anchorage, AK 99503-3777 | 2007-11-30 |
| 1376638171 | Providence Health & Services - Washington | Skilled Nursing Facility | 4900 Eagle St, Anchorage, AK 99503-7446 | 2006-10-04 |
| 1124025507 | Providence Health & Services Washington | Skilled Nursing Facility | 910 Compassion Circle, Anchorage, AK 99504-1645 | 2005-06-30 |
| 1215167382 | Providence Health and Services Alaska | Skilled Nursing Facility | 4900 Eagle St, Anchorage, AK 99503-7446 | 2009-07-22 |
| 1801021290 | Care Center Anchorage Inc. | Skilled Nursing Facility | 9100 Centennial Cir, Anchorage, AK 99504-1480 | 2009-05-28 |
| 1285729087 | Providence Health System - Washington | Skilled Nursing Facility | 9100 Centennial Cir, Anchorage, AK 99504-1480 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
| 1821438342 | Yukon-kuskokwim Health Corporation | Skilled Nursing Facility | 1100 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2013-06-28 |
| 1518240084 | Maniilaq Association | Skilled Nursing Facility | 436 Mission St, Kotzebue, AK 99752-0510 | 2011-09-21 |
| 1821102757 | City of Seward | Skilled Nursing Facility | 2203 Oak Street, Seward, AK 99664 | 2006-08-18 |
| 1790715928 | City of Valdez | Skilled Nursing Facility | 911 Meals Avenue, Valdez, AK 99686 | 2006-07-04 |
| 1821036880 | Denali Center | Skilled Nursing Facility | 1510 19th Ave, Fairbanks, AK 99701-5900 | 2006-06-03 |
| 1255302386 | Wildflower Court Inc | Skilled Nursing Facility | 2000 Salmon Creek Ln, Juneau, AK 99801-7801 | 2006-01-27 |
| 1356901961 | Southeast Alaska Regional Health Consortium | Skilled Nursing Facility | 209 Moller Ave, Sitka, AK 99835-7142 | 2019-06-17 |
| 1396223210 | Southeast Alaska Regional Health Consortium | Skilled Nursing Facility | 310 Bennett St, Wrangell, AK 99929 | 2018-08-02 |
| 1326597410 | Denali Center, LLC | Skilled Nursing Facility | 1510 19th Ave, Fairbanks, AK 99701-5900 | 2016-09-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.