KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1306398250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306398250 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | WEST SALEM MEDICAL OFFICE |
| Practice Address |
1160 Wallace Rd Nw Salem OR 97304-3116 |
| Mailing Address |
500 Ne Multnomah St Portland OR 97232-2023 |
| Practice Telephone | 8008132000 |
| Practice Fax Number | 5032866879 |
| Mailing Telephone | 8008132000 |
| Mailing Fax Number | 5032866879 |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |
| Authorized Official Name | MR. SHAWN BARTON (EXECUTIVE DIRECTOR, REVENUE CYCLE) |
| Authorized Official Telephone | 5038132440 |
| Is Organization Subpart | Y |
| Parent Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| West Salem Medical Office | Other Name - Individual/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 |
| 1093142234 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 1700 Ne 102nd Ave., Portland, OR 97220 | 2013-10-02 |
| 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 |
| 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 |
1160 WALLACE RD NW |
| City | SALEM |
| State | OR |
| Zip Code | 97304-3116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760450308 | Barbara G C Hoover | Family Medicine | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2006-03-09 |
| 1235789298 | Dorian Truong | Physician Assistant | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2019-09-11 |
| 1003235474 | Bethany Wohletz | Family Medicine | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2014-04-14 |
| 1174768576 | Tatiana O Anderson | Pharmacist | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2008-12-14 |
| 1598919565 | Kaiser Foundation Health Plan of The Northwest | Clinical Medical Laboratory | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2008-11-04 |
| 1437306578 | Kaiser Foundation Health Plan of The Northwest | Clinic/Center | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2008-08-20 |
| 1609043116 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2008-05-14 |
| 1760668636 | Steven R Thorvilson | Pharmacist | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2008-01-10 |
| 1851584700 | Suzanne Marie Deschamps | Family Medicine | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2007-08-23 |
| 1043392012 | Mark Warren Olson | Family Medicine | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2006-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114413010 | Sam Mackenzie Lane | Massage Therapist | 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 | 2018-07-03 |
| 1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
| 1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
| 1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
| 1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
| 1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
| 1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
| 1336401017 | Trillium Family Services | Community/Behavioral Health | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2012-06-08 |
| 1033428198 | Kathleen Ketelson | Nurse Practitioner | 560 Wallace Rd Nw Ste 140, Salem, OR 97304 | 2010-10-06 |
| 1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
| Find all providers in zip 97304 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821342429 | Stephanie Nicole Reedy | General Practice | 2515 Liberty St Ne, Salem, OR 97301-8386 | 2012-11-04 |
| 1427207265 | John M Vargo | General Practice | 4305 Camas Ct Ne, Salem, OR 97305-2207 | 2008-09-17 |
| 1275797417 | Lagrand Johnson | General Practice | 326 Highway 6, Salem, UT 84653-5620 | 2008-07-16 |
| 1235392242 | John Mark Pozar | General Practice | 998 Capitol St Ne, Salem, OR 97301-1201 | 2008-07-09 |
| 1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
| 1104028364 | Ivan Dassenko | General Practice | 6810 Canyon St Se, Salem, OR 97317-9024 | 2007-06-01 |
| 1073668935 | Terence H Young | General Practice | 1205 Wallace Rd Nw, Salem, OR 97304-3007 | 2007-01-23 |
| 1639243348 | Thomas R Howard | General Practice | 567 Salem Quinton Rd, Ste C, Salem, NJ 08079-1255 | 2006-11-17 |
| 1023083722 | Brent K. Caudill | General Practice | Hwy 72 N, Salem, MO 65560 | 2006-02-17 |
| 1316456965 | Anton Dubrick Md Sc | General Practice | 420 W Schwartz St, Salem, IL 62881-1552 | 2017-09-27 |
| Find all providers in SALEM | ||||
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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.