KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1366497778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366497778 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | KAISER PERMANENTE BEAVERTON PHARMACY |
| Practice Address |
4855 Sw Western Ave Beaverton OR 97005-3460 |
| Practice Telephone | 8662791751 |
| Practice Fax Number | 5036264419 |
| Mailing Telephone | 8662791751 |
| Mailing Fax Number | 5036264419 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | ALFRED LYMAN (EXECUTIVE DIRECTOR, REGIONAL PHARMA) |
| Authorized Official Telephone | 8008132000 |
| Authorized Official Credential | PHARMD, BCPS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers | ||
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
RP-0000136-CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2077258 | 01 | |
| OR | 136791 | 05 | |
| WA | 6019467 | 05 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Beaverton 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 |
| 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 |
4855 SW WESTERN AVE |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97005-3460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407827694 | Jennifer Mae Soyke | Family Medicine | 4855 Sw Western Ave, University of Oregon, Beaverton, OR 97005-3460 | 2006-01-27 |
| 1043857105 | Reagan Ravanzo Blanco | Dental Assistant | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2019-12-06 |
| 1144866591 | Asela Agtay Wells | Dental Assistant | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2019-11-20 |
| 1851935969 | Rosilyn Ricard | Dental Assistant | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2019-10-31 |
| 1063074789 | Blake Mcconnell | Student in an Organized Health Care Education/Training Program | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2019-07-02 |
| 1154886877 | Sarah Elizabeth Anderson Mills | Dental Assistant | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2019-02-06 |
| 1023506219 | Amanda Ellen Koonce | Student in an Organized Health Care Education/Training Program | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2018-04-24 |
| 1285142802 | Tiffani O'neill | Counselor | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2018-01-17 |
| 1912438953 | Dia Hazra | Pediatrics | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2017-03-22 |
| 1346782794 | Nicole Pollock | Pharmacist | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2016-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945053 | Krista Lowe Schimmelbusch | Student in an Organized Health Care Education/Training Program | 12730 Sw 3rd St., Beaverton, OR 97005 | 2020-06-05 |
| 1346882578 | Mireya Elissa Nunez I | Counselor | 12665 Sw Center Street, Suite 100, Beaverton, OR 97005 | 2019-10-09 |
| 1548816879 | Logan James Patzlaff | Behavior Technician | 6200 Sw Artic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-08-13 |
| 1528521424 | Alex Taylor Foerman | Behavior Technician | 6200 Sw Arctic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-04-09 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1992286348 | Kathryn Wallner | Counselor | 14205 Sw Farmington Road, Suite 160, Beaverton, OR 97005 | 2018-08-23 |
| 1699265058 | Meaghan Mikulic | Social Worker | 14355 Sw Allen Blvd Suite 150, Beaverton, OR 97005 | 2018-05-11 |
| 1629568936 | Aimee J Nelson | Massage Therapist | 10700 Sw Beaverton Hillsdale Hwy Ste 465, Beaverton, OR 97005 | 2018-05-11 |
| 1093221780 | Ember Dahl | Massage Therapist | 12655 Sw Center St Ste 530, Beaverton, OR 97005 | 2017-12-18 |
| 1033667456 | Andre Vo | Pharmacist | 2575 Sw Walker Rd, Beaverton, OR 97005 | 2016-09-14 |
| Find all providers in zip 97005 | ||||
| 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 |
|---|---|---|---|---|
| 1508876319 | Virginia Garcia Memorial Health Center | Pharmacy | 2935 Sw Cedar Hills Blvd, Beaverton, OR 97005-1342 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427346543 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5381 E Main St, Hillsboro, OR 97123-6447 | 2011-07-11 |
| 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 |
| 1578630463 | Good Shepherd Health Care Systems | Pharmacy | 600 Nw 11th St Ste E04, Hermiston, OR 97838-8602 | 2006-11-29 |
| 1275548059 | Multnomah County Oregon | Pharmacy | 600 Ne 8th St Fl 3, Gresham, OR 97030-7317 | 2006-07-30 |
| 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 |
| 1063040186 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 360 S Garden Way Ste 120, Eugene, OR 97401-8173 | 2020-04-01 |
| Find all providers with the same taxonomy | ||||
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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.