KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1730108168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730108168 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | KAISER PERMANENTE INTERSTATE SOUTH PHARMACY |
| Practice Address |
3500 N Interstate Ave Portland OR 97227-1196 |
| Mailing Address |
5725 Ne 138th Ave Portland OR 97230-3409 |
| Practice Telephone | 5033316186 |
| Practice Fax Number | 5033316187 |
| Mailing Telephone | 5032617980 |
| Mailing Fax Number | 5032617567 |
| Enumeration Date | 2006-07-18 |
| 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 | PHNR.FO.60572833 | WA | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
RP-0001643-CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2078923 | 01 | |
| OR | 500622283 | 05 | |
| WA | 6029821 | 05 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Interstate South 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 |
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 |
| 1467903013 | Kaiser Foundation Health Plan of The Northwest | General Practice | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2016-10-19 |
| 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 |
| 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 | 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.