Organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Active
Other names
KAISER PERMANENTE COMMUNITY CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED LYMAN PHARMD, BCPS (EXECUTIVE DIRECTOR, REGIONAL PHARMA)
(800) 813-2000
Entity
Organization
Contact information
Practice address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-7927
(503) 261-2015
Mailing address
5717 NE 138TH AVE, PORTLAND, OR 97230
(503) 261-7927
(503) 261-2015
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
PHNR.FO.00058658
WA
3336L0003X
Long Term Care Pharmacy
Primary
RP00002128-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2079265
PK
—
05
—
230431
—
OR
05
—
6028047
—
WA
Enumeration date
06/06/2006
Last updated
06/01/2021
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