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General NPI Number Information
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NPI Number | 1386422996
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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 | 09/15/2023
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 4816 NE THURSTON WAY
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City | VANCOUVER
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State | WA
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Zip | 98662-6661
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Country | US
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Telephone | 800-813-2000
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Fax |
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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 |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. 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 | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State |
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