KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1649686999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649686999 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | KAISER PERMANENTE INTERSTATE SPECIALTY PHARMACY |
| Practice Address |
3550 N Interstate Ave Portland OR 97227-1196 |
| Mailing Address |
5725 Ne 138th Ave Portland OR 97230-3409 |
| Practice Telephone | 8662798038 |
| Practice Fax Number | 5032493447 |
| Mailing Telephone | 8662798038 |
| Mailing Fax Number | 5032493447 |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2017-02-13 |
| Authorized Official Name | ALFRED E. LYMAN JR. (EXEC DIRECTOR, PHARMACY SERVICES) |
| Authorized Official Telephone | 5032617980 |
| Authorized Official Credential | PHARMD., BCPS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
RP-0002945-CS-C | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2146706 | 01 | |
| OR | 500678728 | 05 | |
| WA | 2042316 | 05 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Interstate Specialty 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 |
3550 N INTERSTATE AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1196 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255335295 | Brenda R Annotti | Registered Nurse | 3550 N Interstate Ave, Portland, OR 97227 | 2005-06-08 |
| 1124633326 | Ajna Rae | Counselor | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2020-09-14 |
| 1649822420 | Rosa Ahn | Student in an Organized Health Care Education/Training Program | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2019-07-12 |
| 1154882132 | Casey Grad Granbois | Student in an Organized Health Care Education/Training Program | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2019-03-30 |
| 1750855425 | Julie Catherine Leffler | Student in an Organized Health Care Education/Training Program | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2019-01-16 |
| 1487125738 | John Mark Custer | Social Worker | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2018-12-16 |
| 1548776842 | Heather Jacobs | Registered Nurse | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2017-12-21 |
| 1245764075 | Ryan Nesbit | Student in an Organized Health Care Education/Training Program | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2017-04-19 |
| 1023552460 | Chia Neng Vang | Pharmacist | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2016-12-04 |
| 1295278307 | Fideliz Enrile Lim | Pharmacist | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2016-11-21 |
| 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 | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| 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 |
|---|---|---|---|---|
| 1205399011 | Vfc Pharmacy #101 LLC | Pharmacy | 12 Mountfort St, Portland, ME 04101-4307 | 2019-04-09 |
| 1396125399 | Credena Health LLC | Pharmacy | 6348 Ne Halsey St, Suite A, Portland, OR 97213-4720 | 2015-06-04 |
| 1902975113 | Apria Healthcare, Inc. | Pharmacy | 12029 Ne Glenn Widing Dr, Portland, OR 97220-9050 | 2006-11-06 |
| 1962832071 | Ardon Health, LLC | Pharmacy | 11835 Ne Glenn Widing Dr, Portland, OR 97220-9057 | 2013-11-26 |
| 1295901197 | Healthy Options Inc. | Pharmacy | 3500 Se 26th Ave, Portland, OR 97202-2901 | 2008-05-01 |
| 1790878965 | Oregon Health and Science University | Pharmacy | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528306081 | Rxmedlab Pharmacy, LLC | Pharmacy | 162 Ne Beacon Dr, Suite # 109, Grants Pass, OR 97526-4260 | 2013-01-17 |
| 1922018639 | Peacehealth Medical Group | Pharmacy | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2006-08-08 |
Please comment or provide details below to improve the information on KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST.
| 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.