PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL – Critical Access Hospital, NPI 1629054374

PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL is a healthcare provider. based in Portland, Oregon. specializing in Critical Access Hospital. The organization holds a License No. 285 (AK). The NPI Number for PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL is 1629054374

Main info

Organization
Name
PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL
NPI
1629054374
Phone
(907) 486-9550
Address
PO BOX 3706
Authorized Official
DONALD WAYNE ANDERSON JR. ASSISTANT SECRETARY OF ENROLLMENTS
Enumeration Date
15 December 2005
Last Update Date
13 May 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL

  • 3706, Northeast Maywood Place, Maywood Park, Portland, Metro, Multnomah County, Oregon, 97220, United States

    PORTLAND, OR 972083706

    Phone: (907) 486-9550

    Fax: (907) 486-9553

    Type: Mailing

  • 1915, East Rezanof Drive, Kodiak, Kodiak Island, Alaska, 99615, United States

    KODIAK, AK 996156602

    Phone: (907) 486-9550

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97208)

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Reviews

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Frequently asked questions

Does PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL have a public NPI I can cite?
Public records show PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL under NPI 1629054374.
Is PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL currently accepting referrals based on NPI status?
Registry metadata lists PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL as active.
Which specialty label fits PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL?
NPPES ties PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL to Critical Access Hospital in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL?
The directory associates PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL with Portland, Oregon. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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