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General NPI Number Information
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NPI Number | 1245382753
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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 | 01/17/2007
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 13705 NE AIRPORT WAY
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City | PORTLAND
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State | OR
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Zip | 97230-1048
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Country | US
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Telephone | 503-258-6800
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Fax | 503-258-6865
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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 | 503-813-4939
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Fax | 503-813-4967
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Authorized Official
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Title or Position | REVENUE CYCLE
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Name | TAMMY T MCCULLER
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Credential |
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Telephone | 503-714-3035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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