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
2400 LANCASTER DR NE
SALEM, OR97305-1221
Phone: 866-280-1563
Fax: 503-375-5730
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X
Managed Care Organization Pharmacy 3336M0003X

* Indicates primary specialty

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

NPI Number 1801834510
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 06/03/2006
Last updated 06/01/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • OR License #: RP-0000757-CS
  • OR Medicaid: 136718
  • WA Medicaid: 6019491
  • Other: 2078430 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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