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Organization

KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST

Active
Other names
KAISER DIVISION PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
STEVE LOGAN R.PH. (DIRECTOR, PHARMACY OPERATIONS)
(503) 261-7566
Entity
Organization

Contact information

Practice address
7705 SE DIVISION ST, PORTLAND, OR 97206-1059
(503) 777-3311
(503) 788-6007
Mailing address
7705 SE DIVISION ST, PORTLAND, OR 97206-1059
(503) 777-3311
(503) 788-6007

Taxonomy

Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
RP0000426
OR
3336M0003X
Managed Care Organization Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
136643
OR
01
3803930
NCPDP PROVIDER IDENTIFICATION NUMBER
05
6019426
WA
Enumeration date
05/26/2006
Last updated
06/01/2021
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