Organization · Type 2 NPI

Kaiser Foundation Health Plan of the Northwest

Managed Care Organization Pharmacy · Portland, OR

NPI number 1013963131 Active

Practice location

3550 N Interstate Ave
Portland, OR 97227-1196

Fax (503) 249-3438

Specialties and licenses

Taxonomy	Code	License
Clinic Pharmacy	3336C0002X	None listed
Managed Care Organization Pharmacy Primary	3336M0003X	RP-0000717-CS (OR)

Managed Care Organization Pharmacy: A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO's covered members only.

235 other providers at this address

NPI record

NPI: 1013963131
Entity type: Organization (Type 2)
Issued: May 26, 2006
Last updated: Jun 23, 2022
Status: Active

Other names

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Kaiser Permanente East Interstate Pharmacy · doing business as
Kaiser Permanente East Interstate Pharmacy · doing business as

Authorized official

Stephen Shawn Barton
Executive Director, Revenue Cycle
(800) 813-2000

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1013963131

Kaiser Foundation Health Plan of the Northwest's National Provider Identifier is 1013963131, issued on May 26, 2006. The primary taxonomy on file is Managed Care Organization Pharmacy (3336M0003X), and the practice location is in Portland, OR. The record was last updated on Jun 23, 2022.