Organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Active
Other names
Kaiser Permanente East Interstate Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN SHAWN BARTON (EXECUTIVE DIRECTOR, REVENUE CYCLE)
(800) 813-2000
Entity
Organization
Contact information
Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(866) 279-6122
(503) 249-3438
Mailing address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(866) 279-6122
(503) 249-3438
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
Primary
RP-0000717-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136650
—
OR
01
—
2077391
PK
—
05
—
6019418
—
WA
Enumeration date
05/26/2006
Last updated
06/23/2022
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