Organization · Type 2 NPI

Kaiser Foundation Health Plan of the Northwest

Clinic Pharmacy · Keizer, OR

NPI number 1689077000 Active

Practice location

5940 Ulali Dr NE
Keizer, OR 97303-1500

Call (844) 854-9364 Map

Fax (503) 304-5721

Mailing address

5725 NE 138th Ave
Portland, OR 97230-3409

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Clinic Pharmacy Primary	3336C0002X	RP-0002984 (OR)

Clinic Pharmacy: A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

19 other providers at this address

NPI record

NPI: 1689077000
Entity type: Organization (Type 2)
Issued: Sep 30, 2014
Last updated: Jun 1, 2021
Status: Active

Other names

<unavail>
Kaiser Permanente Keizer Station Pharmacy · doing business as
Kaiser Permanente Keizer Station Pharmacy · doing business as

Authorized official

Alfred E. Lyman, PHARMD., BCPS
Exec Director Regional Pharmacy
(503) 261-7980

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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 1689077000

Kaiser Foundation Health Plan of the Northwest's National Provider Identifier is 1689077000, issued on Sep 30, 2014. The primary taxonomy on file is Clinic Pharmacy (3336C0002X), and the practice location is in Keizer, OR. The record was last updated on Jun 1, 2021.