Organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Active
Other names
Kaiser Permanente Longview Kelso Oncology Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE LOGAN RPH (EXEC. DIRECTOR PHARMACY SERVICES)
(503) 261-7566
Entity
Organization
Contact information
Practice address
1230 7TH AVE., LONGVIEW, WA 98682
(866) 279-8943
(360) 636-6271
Mailing address
5725 NE 138TH AVE., PORTLAND, OR 97230-3409
(503) 261-2166
(503) 261-2166
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHAR.CF.60362983
WA
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6019384
—
WA
01
—
PHAR.CF.60362983WA
BOP LICENSE
WA
Enumeration date
10/17/2013
Last updated
06/01/2021
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