Organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Active
Other names
Kaiser Permanente Skyline Institutional Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED E. LYMAN JR. PHARMD., BCPS (EXEC. DIRECTOR PHARMACY SERVICES)
(503) 261-7980
Entity
Organization
Contact information
Practice address
5125 SKYLINE RD S, SALEM, OR 97306-9427
(503) 315-4650
(503) 315-4682
Mailing address
5725 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 315-4650
(503) 315-4682
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3845522
NCPDP
OR
05
—
500687040
—
OR
01
—
RP0003050CS
STATE LICENSE
OR
Enumeration date
03/20/2015
Last updated
03/07/2023
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