KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1174075154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174075154 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | SKYLINE MEDICAL OFFICE |
| Practice Address |
5125 Skyline Rd S Salem OR 97306-9427 |
| Mailing Address |
500 Ne Multnomah St Portland OR 97232-2023 |
| Practice Telephone | 8008132000 |
| Practice Fax Number | 5032403933 |
| Mailing Telephone | 8008132000 |
| Mailing Fax Number | 5032866879 |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |
| Authorized Official Name | MR. SHAWN BARTON (EXECUTIVE DIRECTOR, REVENUE CYCLE) |
| Authorized Official Telephone | 5038132440 |
| Is Organization Subpart | Y |
| Parent Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Skyline Medical Office | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588153076 | Kaiser Foundation Health Plan of The Northwest | Clinic/Center | 3060 Se Hawthorne Blvd, Portland, OR 97214-4121 | 2018-05-09 |
| 1992242093 | Kaiser Foundation Health Plan of The Northwest | Dentist | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2017-01-26 |
| 1801333901 | Kaiser Foundation Health Plan of The Northwest | General Practice | 3175 Nw Aloclek Dr, Hillsboro, OR 97124-7135 | 2017-01-26 |
| 1790113371 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 1230 7th Ave., Longview, WA 98682 | 2013-10-17 |
| 1093142234 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 1700 Ne 102nd Ave., Portland, OR 97220 | 2013-10-02 |
| 1427346543 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5381 E Main St, Hillsboro, OR 97123-6447 | 2011-07-11 |
| 1215976014 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5717 Ne 138th Ave, Portland, OR 97230-3409 | 2006-06-06 |
| 1801834510 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 2400 Lancaster Dr Ne, Salem, OR 97305-1221 | 2006-06-03 |
| 1568418051 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 7705 Se Division St, Portland, OR 97206-1059 | 2006-05-26 |
| 1962456194 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5725 Ne 138th Ave, Portland, OR 97230-3409 | 2006-05-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | One Kaiser Plaza, Oakland, CA 94612 |
| Washington State Corporations | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | One Kaiser Plaza, Oakland, CA 94612 |
| Street Address |
5125 SKYLINE RD S |
| City | SALEM |
| State | OR |
| Zip Code | 97306-9427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407826563 | Christian A Speer | Internal Medicine | 5125 Skyline Rd S, Gastroenterology, Salem, OR 97306-9427 | 2006-01-23 |
| 1881249597 | Anastasiya Makarenko | Student in an Organized Health Care Education/Training Program | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2019-08-08 |
| 1457803587 | Lilian May | Pharmacist | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2016-10-24 |
| 1700336138 | Darryl Johnson | Pharmacist | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2016-10-10 |
| 1740739937 | Marilee Neuschwander | Pharmacist | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2016-09-28 |
| 1548716921 | Barbara Ann Schnabel | Pharmacist | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2016-08-26 |
| 1720457922 | Bryan Hurliman | Pharmacist | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2015-09-17 |
| 1629453527 | Mary Katherine Burch | Pharmacist | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2015-07-21 |
| 1366836041 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2015-03-20 |
| 1821490707 | Corinne Tower Coldwell Larson | Speech-Language Pathologist | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2014-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134609050 | Andrea P Merryman | Dental Assistant | 5135 Skyline Rd South, Salem, OR 97306 | 2018-08-20 |
| 1215470315 | Anthony Quoc Ngo | Nurse Practitioner | 5050 Skyline Village Loop, Salem, OR 97306 | 2016-11-22 |
| 1134521305 | Wendy Poling | Occupational Therapy Assistant | 1966 Madras St Se Apt 1082, Salem, OR 97306 | 2014-09-19 |
| 1659601045 | Monarch Medical Group LLC | Clinic/Center | 5686 Commercial St Se, Suite 100, Salem, OR 97306 | 2010-01-06 |
| 1316188006 | Judith A Mitchell | Physician Assistant | 4999 Skyline Rd. S., Salem, OR 97306 | 2009-03-10 |
| 1164685574 | Leon Chira | Pharmacist | 2431 Concomly Rd S, Salem, OR 97306 | 2008-07-07 |
| 1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
| 1326257486 | Robert Allen Long | Physical Therapist | 6250 Commercial St N.e., Salem, OR 97306 | 2007-05-22 |
| 1922137504 | Charlene Garbutt | Dental Assistant | 5135 Skyline Rd. S., Salem, OR 97306 | 2007-03-02 |
| 1417085747 | Michelle West | Dental Assistant | 5135 Skyline R S, Salem, OR 97306 | 2007-02-28 |
| Find all providers in zip 97306 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821342429 | Stephanie Nicole Reedy | General Practice | 2515 Liberty St Ne, Salem, OR 97301-8386 | 2012-11-04 |
| 1427207265 | John M Vargo | General Practice | 4305 Camas Ct Ne, Salem, OR 97305-2207 | 2008-09-17 |
| 1275797417 | Lagrand Johnson | General Practice | 326 Highway 6, Salem, UT 84653-5620 | 2008-07-16 |
| 1235392242 | John Mark Pozar | General Practice | 998 Capitol St Ne, Salem, OR 97301-1201 | 2008-07-09 |
| 1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
| 1104028364 | Ivan Dassenko | General Practice | 6810 Canyon St Se, Salem, OR 97317-9024 | 2007-06-01 |
| 1073668935 | Terence H Young | General Practice | 1205 Wallace Rd Nw, Salem, OR 97304-3007 | 2007-01-23 |
| 1639243348 | Thomas R Howard | General Practice | 567 Salem Quinton Rd, Ste C, Salem, NJ 08079-1255 | 2006-11-17 |
| 1023083722 | Brent K. Caudill | General Practice | Hwy 72 N, Salem, MO 65560 | 2006-02-17 |
| 1316456965 | Anton Dubrick Md Sc | General Practice | 420 W Schwartz St, Salem, IL 62881-1552 | 2017-09-27 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.