Organization · Type 2 NPI

Kaiser Foundation Health Plan of the Northwest

General Practice Physician · Portland, OR

NPI number 1356880454 Active

Practice location

500 NE Multnomah St
Portland, OR 97232-2023

Call (800) 813-2000 Map

Fax (503) 286-6879

Mailing address

4709 N Lagoon Ave
Portland, OR 97217-7741

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.

71 other providers at this address

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NPI record

NPI: 1356880454
Entity type: Organization (Type 2)
Issued: Feb 22, 2017
Last updated: Jun 1, 2021
Status: Active
Subpart: Yes of Kaiser Foundation Health Plan of the Northwest

Other names

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Dtna Portland - Health & Wellness Center · other name
Dtna Portland - Health & 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 1356880454

Kaiser Foundation Health Plan of the Northwest's National Provider Identifier is 1356880454, issued on Feb 22, 2017. 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.