Organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Active
Other names
KAISER VANCOUVER 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
2211 E MILL PLAIN BLVD, VANCOUVER, WA 98661-4329
(360) 699-6068
Mailing address
5725 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-7980
(503) 261-7567
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
00001845
WA
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108505
PK
—
05
—
6019319
—
WA
Enumeration date
05/31/2006
Last updated
06/01/2021
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