| NPI | 1790889400 |
|---|---|
| Doing Business As | PROVIDENCE KODIAK ISLAND MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Secretary For Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AK 309115) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2022-03-01 |