KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1093142234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093142234 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | KAISER PERMANENTE GATEWAY PHARMACY |
| Practice Address |
1700 Ne 102nd Ave. Portland OR 97220 |
| Mailing Address |
5725 Ne 138th Ave. Portland OR 97230-3409 |
| Practice Telephone | 8662794581 |
| Practice Fax Number | 9712296861 |
| Mailing Telephone | 5032612166 |
| Mailing Fax Number | 5032612166 |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2016-04-06 |
| Authorized Official Name | STEVE LOGAN (EXEC. DIRECTOR, PHARMACY SERVICES) |
| Authorized Official Telephone | 5032617566 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers | ||
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
RP-0002839-CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500664821 | 05 | |
| OR | BOP LICENSE | RP-0002839-CS | 01 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Gateway Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588153076 | Kaiser Foundation Health Plan of The Northwest | Clinic/Center | 3060 Se Hawthorne Blvd, Portland, OR 97214-4121 | 2018-05-09 |
| 1992242093 | Kaiser Foundation Health Plan of The Northwest | Dentist | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2017-01-26 |
| 1801333901 | Kaiser Foundation Health Plan of The Northwest | General Practice | 3175 Nw Aloclek Dr, Hillsboro, OR 97124-7135 | 2017-01-26 |
| 1790113371 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 1230 7th Ave., Longview, WA 98682 | 2013-10-17 |
| 1427346543 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5381 E Main St, Hillsboro, OR 97123-6447 | 2011-07-11 |
| 1215976014 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5717 Ne 138th Ave, Portland, OR 97230-3409 | 2006-06-06 |
| 1801834510 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 2400 Lancaster Dr Ne, Salem, OR 97305-1221 | 2006-06-03 |
| 1568418051 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 7705 Se Division St, Portland, OR 97206-1059 | 2006-05-26 |
| 1962456194 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5725 Ne 138th Ave, Portland, OR 97230-3409 | 2006-05-20 |
| 1629699863 | Kaiser Foundation Health Plan of The Northwest | Dentist | 9300 Se 91st Ave Ste 310, Happy Valley, OR 97086-3762 | 2020-04-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | One Kaiser Plaza, Oakland, CA 94612 |
| Washington State Corporations | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | One Kaiser Plaza, Oakland, CA 94612 |
| Street Address |
1700 NE 102ND AVE. |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922141415 | Oregon Health and Science University | Pharmacy | 515 Sw Campus Drive, Portland, OR 97239-3098 | 2007-02-14 |
| 1225190408 | Credena Health LLC | Pharmacy | 9155 Sw Barnes Rd Ste 102, Portland, OR 97225-6625 | 2006-12-14 |
| 1528073327 | Multnomah County Oregon | Pharmacy | 619 Nw 6th Ave Fl 1, Portland, OR 97209-3964 | 2006-07-30 |
| 1205841004 | Multnomah County | Pharmacy | 9000 N Lombard St Fl 2, Portland, OR 97203-3006 | 2006-07-30 |
| 1528073319 | Multnomah County | Pharmacy | 5329 Ne Martin L King Fl Jrblvd2, Portland, OR 97211-3237 | 2006-07-30 |
| 1346263340 | Oregon Health & Science University | Pharmacy | 3270 Sw Pavilion Loop, Suite Ppv 110, Portland, OR 97239-3011 | 2006-07-25 |
| 1134189186 | Martins Point Health Care Inc | Pharmacy | 901 Washington Ave, Portland, ME 04103-2737 | 2006-03-24 |
| 1295370377 | Oregon Adult Medicine PC | Pharmacy | 2330 Nw Flanders St Ste 201, Portland, OR 97210-3460 | 2019-11-12 |
| 1437624046 | Central City Concern | Pharmacy | 12121 E Burnside St, Portland, OR 97216-3737 | 2018-10-10 |
| 1154709426 | Oregon Health and Science University | Pharmacy | 3181 Sw Sam Jackson Park Rd, 4c, Portland, OR 97239-3011 | 2015-05-07 |
| Find all providers in PORTLAND | ||||
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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.