Providence Health & Services - Washington

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Practice address

4001 Dale St
Suite 101
Anchorage, AK 99508-5428

Phone

(907) 563-0130

Fax

(907) 563-0135

NPI assigned

Apr 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donald Wayne Anderson Jr.

Title

Assistant Secretary of Enrollments

Phone

(425) 358-9786

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Providence Lifeline Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1083832802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 DALE ST",
            "address_2": "SUITE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085428",
            "telephone_number": "907-563-0130",
            "fax_number": "907-563-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 DALE ST",
            "address_2": "SUITE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085428",
            "telephone_number": "907-563-0130",
            "fax_number": "907-563-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES - WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS0012",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Lifeline",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lynne Prossick, LCSW
• Tonie Protzman, MS
• Phoebe Proudfoot
• Sarah Provence
• Providence Anchorage Anesthesia Medical Group, P.C.
• Providence Health & Services - Washington
• Providence Health & Services - Washington
• Providence Health & Services - Washington
• Providence Health & Services - Washington
• Providence Health & Services - Washington

• Durable Medical Equipment & Medical Supplies in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Durable Medical Equipment & Medical Supplies in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.