Organization · Type 2 NPI

Kaiser Foundation Health Plan of the Northwest

General Practice Physician · Salem, OR

NPI number 1174075154 Active

Practice location

5125 Skyline Rd S
Salem, OR 97306-9427

Call (800) 813-2000 Map

Fax (503) 240-3933

Mailing address

500 NE Multnomah St
Portland, OR 97232-2023

Specialties and licenses

Taxonomy	Code	License
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.

125 other providers at this address

Other general practice physician providers in Salem

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NPI record

NPI: 1174075154
Entity type: Organization (Type 2)
Issued: Oct 26, 2016
Last updated: Jun 1, 2021
Status: Active
Subpart: Yes of Kaiser Foundation Health Plan of the Northwest

Other names

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Skyline Medical Office · other name
Skyline Medical Office · 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 1174075154

Kaiser Foundation Health Plan of the Northwest's National Provider Identifier is 1174075154, issued on Oct 26, 2016. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Salem, OR. The record was last updated on Jun 1, 2021.