Organization · Type 2 NPI

Kaiser Foundation Health Plan of the Northwest

General Practice Physician · Portland, OR

NPI number 1063990695 Active

Practice location

3060 SE Hawthorne Blvd
Portland, OR 97214-4121

Call (800) 813-2000 Map

Fax (503) 286-6879

Mailing address

500 NE Multnomah St
Portland, OR 97232-2023

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Internal Medicine Physician	207R00000X	None listed
Pediatrics Physician	208000000X	None listed
General Practice Physician Primary	208D00000X	None listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

5 other providers at this address

Other general practice physician providers in Portland

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NPI record

NPI: 1063990695
Entity type: Organization (Type 2)
Issued: Aug 6, 2018
Last updated: Jun 1, 2021
Status: Active
Subpart: Yes of Kaiser Foundation Health Plan of the Northwest

Other names

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Care Essentials By Kaiser Permanente - Hawthorne · doing business as
Care Essentials By Kaiser Permanente - Hawthorne · doing business as

Authorized official

Stephen Shawn Barton
Executive Director, Revenue Cycle
(503) 813-2440

Verify this record

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 1063990695

Kaiser Foundation Health Plan of the Northwest's National Provider Identifier is 1063990695, issued on Aug 6, 2018. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Portland, OR. The record was last updated on Jun 1, 2021.