Organization
KAISER FOUNDATION HEALTH PLAN NORTHWEST
Active
Other names
Kaiser Fisher's Landing Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE HUMPHREY R.PH. (SUPERVISOR)
(360) 735-5274
Entity
Organization
Contact information
Practice address
16703 SE MCGILLIVRAY BLVD, VANCOUVER, WA 98683-4300
(360) 735-5645
(360) 735-5646
Mailing address
16703 SE MCGILLIVRAY BLVD, VANCOUVER, WA 98683-4300
(360) 735-5645
(360) 735-5646
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
05462
WA
3336M0003X
Managed Care Organization Pharmacy
05462
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138151
—
OR
01
—
4925383
NCPDP
WA
05
—
6019483
—
WA
Enumeration date
05/26/2006
Last updated
06/01/2021
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