# KAISER FOUNDATION HEALTH PLAN

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KAISER FOUNDATION HEALTH PLAN
- **Other names:** Central Interstate Medical Office
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285960732
- **Legal business name:** KAISER FOUNDATION HEALTH PLAN
- **Authorized official:** STEPHEN SHAWN BARTON (EXECUTIVE DIRECTOR, REVENUE CYCLE)
- **Authorized official phone:** (503) 813-2440

## Contact information

- **Practice address:** 3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
- **Practice address phone:** (503) 528-7458
- **Mailing address:** 500 NE MULTNOMAH ST, PORTLAND, OR 97232-2023
- **Mailing address phone:** (503) 813-4939
- **Mailing address fax:** (503) 813-4967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/19/2009
- **Last updated:** 06/01/2021