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General NPI Number Information
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NPI Number | 1487711412
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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 | 01/02/2007
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Last Update Date | 04/12/2022
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Provider Practice Location 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 | 503-499-5200
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Fax | 503-499-5212
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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 | DIR, SRVS AREA CONT OF CARE
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Name | MR. JOHN D KENDRICK
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Credential |
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Telephone | 360-801-9655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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