National Provider Identifier Database

KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
3600 N INTERSTATE AVE
PORTLAND, OR97227-1106
Phone: 503-331-6570
Fax: 503-331-6575
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X
Managed Care Organization Pharmacy 3336M0003X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST

NPI Number 1407803513
Legal business name
LBN
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Authorized official ALFRED LYMAN - (EXECUTIVE DIRECTOR, REGIONAL PHARMA)
Entity Organization
Organization subpart No
Enumeration date 05/27/2006
Last updated 06/01/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • OR License #: RP-0001284-CS
  • WA License #: PHNR.FO.60658960
  • OR Medicaid: 136635
  • WA Medicaid: 6019434
  • Other: 2078433 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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