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General NPI Number Information
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NPI Number | 1396810701
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Entity Type | Organization
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Legal Business Name | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 320 WESTLAKE AVE. N. SUITE 100
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City | SEATTLE
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State | WA
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Zip | 98109-5233
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Country | US
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Telephone | 206-448-6561
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34584
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City | SEATTLE
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State | WA
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Zip | 98124-1584
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Country | US
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Telephone | 509-241-7349
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Fax | 509-241-7628
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Authorized Official
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Title or Position | MANAGER
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Name | MICHELLE BARLOW
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Credential |
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Telephone | 509-241-7343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 478001461
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License Number State | WA
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