KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1467903013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467903013 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | INTERSTATE MEDICAL OFFICE SOUTH |
| Practice Address |
3500 N Interstate Ave Portland OR 97227-1196 |
| 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 | 2016-10-19 |
| Last Update Date | 2016-10-19 |
| 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 |
|---|---|
| Interstate Medical Office South | 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 |
3500 N INTERSTATE AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1196 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972542009 | Gregory J Davenport | Physician Assistant | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2006-06-05 |
| 1922513910 | Emily A Vanlaningham | Social Worker | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2017-12-12 |
| 1770026023 | Debra Viegas | Pharmacist | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2016-11-18 |
| 1619419942 | Stephen Glenn | Pharmacist | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2016-11-17 |
| 1871043422 | Robbi Shannon | Pharmacist | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2016-10-06 |
| 1801125521 | Lucie Krenek | Orthopaedic Surgery | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2009-12-08 |
| 1366779019 | Diana Muresan | Pulmonary Function Technologist | 3500 N Interstate Ave, Portland, OR 97227 | 2009-11-17 |
| 1811141880 | Kaiser Foundation Health Plan of The Northwest | Clinical Medical Laboratory | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2008-11-04 |
| 1255581385 | Sheila Ann Jiroch | Respiratory Therapist, Registered | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2008-09-25 |
| 1407006471 | Richard A Corneliuz | Pulmonary Function Technologist | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2008-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1346751443 | Providence Health & Services Oregon | General Practice | 4400 Ne Halsey St, Pop 2, 3rd Floor, Portland, OR 97213-1545 | 2017-10-16 |
| 1336697143 | Rita Lawler | General Practice | 8353 Se Clatsop Ct, Portland, OR 97266-6159 | 2016-09-21 |
| 1235526849 | Hollis Lule Augee | General Practice | 5151 S.w. 88th Ave., Portland, OR 97225-1717 | 2015-04-21 |
| 1093134496 | Red Leaf Natural Health Clinic | General Practice | 833 Sw 11th Ave Ste 1018, Portland, OR 97205-2124 | 2014-04-14 |
| 1861770190 | Jeffrey Owen Pentecost | General Practice | 3574 Se Harold Ct, Portland, OR 97202-4344 | 2011-08-03 |
| 1255651592 | Nic Group Inc | General Practice | 8383 Ne Sandy Blvd Ste 320dd, Portland, OR 97220-4968 | 2010-06-09 |
| 1619296985 | Thcf | General Practice | 105 Se 18th Ave, Portland, OR 97214-1559 | 2010-05-25 |
| 1518106640 | Keith C Klopfer | General Practice | 1601 Sw Pendleton St, Portland, OR 97239-2619 | 2009-02-12 |
| 1275793424 | Harriet Cooke | General Practice | 2929 Sw Multnomah Blvd Ste 301, Portland, OR 97219-4072 | 2008-06-11 |
| 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.