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NPI Code Detail

MEDICARE: KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST

MEDICARE: KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588153076
Entity Type Code : Organization
Provider Name (Legal Business Name) : KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Provider Business Mailing Address
First Line : 500 NE MULTNOMAH ST STE 100
Second Line :
City : PORTLAND
State : OR
Zip : 97232-2099
Country : US
Telephone Number : 800-813-2000
Fax Number : 503-286-6879
Provider Business Practice Location Address
First Line : 3060 SE HAWTHORNE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97214-4121
Country : US
Telephone Number : 800-813-2000
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR, REVENUE CYCLE
Name : STEPHEN SHAWN BARTON
Credential :
Telephone Number : 503-813-2440
Provider Enumeration Date : 05/09/2018
Last Update Date : 06/01/2021

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Directions to “KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST ” Practice Location

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