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General NPI Number Information
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NPI Number | 1891962049
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Entity Type | Organization
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Legal Business Name | KAISER PERMANENTE
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 6902 SE LAKE RD SUITE 100
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City | MILWAUKIE
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State | OR
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Zip | 97267-2148
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Country | US
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Telephone | 503-786-1152
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Fax |
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Provider Business Mailing Address
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Address Line | 6902 SE LAKE RD SUITE 100
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City | MILWAUKIE
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State | OR
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Zip | 97267-2148
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Country | US
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Telephone | 503-786-1152
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Fax |
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Authorized Official
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Title or Position | MEDICAL SOCIAL WORKER
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Name | MR. DAVID GREGORY PLEIMAN
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Credential | MSW
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Telephone | 503-786-1152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 048048
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License Number State | OR
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