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General NPI Number Information
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NPI Number | 1770244568
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Entity Type | Organization
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Legal Business Name | EXPRESS CARE AK LLC
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 1200 W NORTHERN LIGHTS BLVD STE B
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City | ANCHORAGE
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State | AK
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Zip | 99503-3652
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Country | US
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Telephone | 907-212-5165
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5608
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City | PORTLAND
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State | OR
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Zip | 97228-5608
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Country | US
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Telephone | 888-227-3312
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECRETARY OF ENROLLMENTS
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Name | DONALD WAYNE ANDERSON JR.
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Credential |
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Telephone | 425-358-9786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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