Organization · Type 2 NPI

Kaiser Foundation Health Plan of the Northwest

Clinic Pharmacy · Portland, OR

NPI number 1730108168 Active

Practice location

3500 N Interstate Ave
Portland, OR 97227-1196

Call (503) 331-6186 Map

Fax (503) 331-6187

Mailing address

5725 NE 138th Ave
Portland, OR 97230-3409

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	PHNR.FO.60572833 (WA)
Clinic Pharmacy Primary	3336C0002X	RP-0001643-CS (OR)
Compounding Pharmacy	3336C0004X	None listed

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.

64 other providers at this address

Other clinic pharmacy providers in Portland

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NPI record

NPI: 1730108168
Entity type: Organization (Type 2)
Issued: Jul 18, 2006
Last updated: Jun 1, 2021
Status: Active

Other names

<unavail>
Kaiser Permanente Interstate South Pharmacy · doing business as
Kaiser Permanente Interstate South Pharmacy · doing business as

Authorized official

Alfred Lyman, PharmD, BCPS
Executive Director, Regional Pharma
(800) 813-2000

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 1730108168

Kaiser Foundation Health Plan of the Northwest's National Provider Identifier is 1730108168, issued on Jul 18, 2006. The primary taxonomy on file is Clinic Pharmacy (3336C0002X), and the practice location is in Portland, OR. The record was last updated on Jun 1, 2021.