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Organization
KAISER FOUNDATION HEALTH PLAN NORTHWEST
Active
Organization
KAISER FOUNDATION HEALTH PLAN NORTHWEST
Active
Other names
Kaiser Fisher's Landing Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE HUMPHREY R.PH. (SUPERVISOR)
(360) 735-5274
Entity
Organization
Contact information
Practice address
16703 SE MCGILLIVRAY BLVD, VANCOUVER, WA 98683-4300
(360) 735-5645
(360) 735-5646
Mailing address
16703 SE MCGILLIVRAY BLVD, VANCOUVER, WA 98683-4300
(360) 735-5645
(360) 735-5646
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
05462
WA
3336M0003X
Managed Care Organization Pharmacy
05462
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138151
—
OR
01
—
4925383
NCPDP
WA
05
—
6019483
—
WA
Enumeration date
05/26/2006
Last updated
06/01/2021
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