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General NPI Number Information
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NPI Number | 1720600141
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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 | 05/07/2020
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 700 LILLY RD NE
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City | OLYMPIA
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State | WA
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Zip | 98506-5115
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Country | US
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Telephone | 360-923-7600
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Fax | 360-923-7609
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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 | 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 | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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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 | 3336M0003X
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Taxonomy Name | Managed Care Organization Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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