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General NPI Number Information
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NPI Number | 1629102637
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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 | 03/15/2007
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 6002 N LIDGERWOOD ST
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City | SPOKANE
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State | WA
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Zip | 99208-1124
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Country | US
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Telephone | 509-482-3110
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Fax | 509-434-3183
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Provider Business Mailing Address
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Address Line | 2921 NACHES AVE SW RCA-B1N-04
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City | RENTON
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State | WA
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Zip | 98057
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Country | US
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Telephone | 206-630-2222
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Fax |
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Authorized Official
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Title or Position | PROGRAM MGR, RX REGULATORY
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Name | GAIL ANN ELLIOTT
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Credential |
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Telephone | 206-630-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | CF00004922
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | CF00004922
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License Number State | WA
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