Organization · Type 2 NPI

Kaiser Foundation Health Plan of the Northwest

General Practice Physician · Tualatin, OR

NPI number 1790236875 Active

Practice location

19185 SW 90th Ave
Tualatin, OR 97062-7558

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
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.

67 other providers at this address

NPI record

NPI: 1790236875
Entity type: Organization (Type 2)
Issued: Oct 24, 2016
Last updated: Jun 1, 2021
Status: Active
Subpart: Yes of Kaiser Foundation Health Plan of the Northwest

Other names

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Tualatin Medical Office · other name
Tualatin Medical Office · other name

Authorized official

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

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 1790236875

Kaiser Foundation Health Plan of the Northwest's National Provider Identifier is 1790236875, issued on Oct 24, 2016. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Tualatin, OR. The record was last updated on Jun 1, 2021.