Organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Active
Other names
KAISER PERMANENTE HOME INFUSION 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) 261-2090
(503) 261-2040
Mailing address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-2090
(503) 261-2040
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHNR58657
WA
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
RP-0002131-CS
OR
3336I0012X
Institutional Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136668
—
OR
01
—
2078366
PK
—
05
—
6019392
—
WA
Enumeration date
06/07/2006
Last updated
06/01/2021
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