# KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KAISER VANCOUVER PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992742894
- **Authorized official:** STEVE LOGAN R.PH. (DIRECTOR, PHARMACY OPERATIONS)
- **Authorized official phone:** (503) 261-7566

## Contact information

- **Practice address:** 2211 E MILL PLAIN BLVD, VANCOUVER, WA 98661-4329
- **Practice address phone:** (360) 699-6068
- **Mailing address:** 5725 NE 138TH AVE, PORTLAND, OR 97230-3409
- **Mailing address phone:** (503) 261-7980
- **Mailing address fax:** (503) 261-7567

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | 00001845 | WA | Yes |
| 3336M0003X | Managed Care Organization Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 05/31/2006
- **Last updated:** 06/01/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2108505 | PK | — |
| 05 | — | 6019319 | — | WA |