Organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Active
Parent organization
KAISER PERMANENTE DENTAL CARE PROGRAM
Other names
Eastmorland Dental Office
Organization subpart
Yes
Provider details
NPI number
Legal business name
KAISER PERMANENTE DENTAL CARE PROGRAM
Authorized official
MR. KENNETH R WRIGHT (VP DENTAL CARE SERVICES)
(503) 813-4660
Entity
Organization
Contact information
Practice address
5025 SE 28TH AVE, PORTLAND, OR 97202-4445
(800) 813-2000
(503) 286-6879
Mailing address
500 NE MULTNOMAH ST, PORTLAND, OR 97232-2023
(800) 813-2000
(503) 286-6879
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/02/2016
Last updated
06/01/2021
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