# KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** KAISER PERMANENTE COMMUNITY CARE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215976014
- **Authorized official:** ALFRED LYMAN PHARMD, BCPS (EXECUTIVE DIRECTOR, REGIONAL PHARMA)
- **Authorized official phone:** (800) 813-2000

## Contact information

- **Practice address:** 5717 NE 138TH AVE, PORTLAND, OR 97230-3409
- **Practice address phone:** (503) 261-7927
- **Practice address fax:** (503) 261-2015
- **Mailing address:** 5717 NE 138TH AVE, PORTLAND, OR 97230
- **Mailing address phone:** (503) 261-7927
- **Mailing address fax:** (503) 261-2015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | PHNR.FO.00058658 | WA | — |
| 3336L0003X | Long Term Care Pharmacy | RP00002128-CS | OR | Yes |

## Other

- **Enumeration date:** 06/06/2006
- **Last updated:** 06/01/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2079265 | PK | — |
| 05 | — | 230431 | — | OR |
| 05 | — | 6028047 | — | WA |