Organization · Type 2 NPI

Kaiser Foundation Health Plan Northwest

Family Medicine Physician · Portland, OR

NPI number 1073030730 Active

Practice location

2930 NE Dekum St
Portland, OR 97211-6613

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
Registered Nurse	163W00000X	None listed
Family Medicine Physician Primary	207Q00000X	None listed
Internal Medicine Physician	207R00000X	None listed
Physician Assistant	363A00000X	None listed
Nurse Practitioner	363L00000X	None listed
Clinical Nurse Specialist	364S00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4 other providers at this address

Other family medicine physician providers in Portland

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NPI record

NPI: 1073030730
Entity type: Organization (Type 2)
Issued: Aug 24, 2017
Last updated: Jun 1, 2021
Status: Active
Subpart: Yes of Kaiser Foundation Health Plan Northwest

Other names

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Kaiser Permanente 3 To PHD Wellness Center · other name

Authorized official

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

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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 1073030730

Kaiser Foundation Health Plan Northwest's National Provider Identifier is 1073030730, issued on Aug 24, 2017. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Portland, OR. The record was last updated on Jun 1, 2021.