Organization
KAISER PERMANENTE
Active
Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER MATTHEW TREHARNE (PHARMACIST)
(503) 338-9840
Entity
Organization
Contact information
Practice address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-7900
Mailing address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-7900
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
RPH-0011874
OR
Other
Enumeration date
10/26/2009
Last updated
10/26/2009
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