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General NPI Number Information
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NPI Number | 1104378140
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Entity Type | Organization
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Legal Business Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 12100 SE STEVENS CT SUITE 106
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City | PORTLAND
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State | OR
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Zip | 97086-4707
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Country | US
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Telephone | 800-813-2000
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Fax | 503-286-6879
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Provider Business Mailing Address
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Address Line | 500 NE MULTNOMAH ST
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City | PORTLAND
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State | OR
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Zip | 97232-2023
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Country | US
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Telephone | 503-813-2000
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Fax | 503-286-6879
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR, REVENUE CYCLE
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Name | STEPHEN SHAWN BARTON
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Credential |
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Telephone | 503-813-2440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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