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General NPI Number Information
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NPI Number | 1366238313
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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 | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 2850 NW NICOLAI ST
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City | PORTLAND
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State | OR
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Zip | 97210-2018
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Country | US
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Telephone | 800-813-2000
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Fax | 855-524-5255
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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 | 800-813-2000
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Fax | 855-524-5255
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | STEPHEN SHAWN BARTON
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Credential |
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Telephone | 503-568-2593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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