KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1306893417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306893417 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | KAISER PERMANENTE LONGVIEW KELSO PHARMACY |
| Practice Address |
1230 7th Ave Longview WA 98632-3166 |
| Mailing Address |
5725 Ne 138th Ave Portland OR 97230-3409 |
| Practice Telephone | 3606366226 |
| Practice Fax Number | 3606366249 |
| Mailing Telephone | 5032617980 |
| Mailing Fax Number | 5032617567 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | ALFRED LYMAN (EXECUTIVE DIRECTOR, REGIONAL PHARMA) |
| Authorized Official Telephone | 8008132000 |
| Authorized Official Credential | PHARMD, BCPS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | CF00002437 | WA | Suppliers |
| N | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers | ||
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
RP-0003090-CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 136676 | 05 | |
| PK | 2108297 | 01 | |
| WA | 6019384 | 05 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Longview Kelso Pharmacy | Doing Business As Name - 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 |
1230 7TH AVE |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-3166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558368597 | Marlene L Dicristina | Family Medicine | 1230 7th Ave, Longview, WA 98632-3166 | 2005-07-06 |
| 1104454743 | Ginnette Erb | Registered Nurse | 1230 7th Ave, Longview, WA 98632-3166 | 2020-03-30 |
| 1952935173 | Amber Griffith | Dental Assistant | 1230 7th Ave, Longview, WA 98632-3166 | 2020-02-26 |
| 1962041996 | Kelli Lynn Jones | Student in an Organized Health Care Education/Training Program | 1230 7th Ave, Longview, WA 98632-3166 | 2019-12-20 |
| 1396389144 | Aleksis Desrosier | Dental Assistant | 1230 7th Ave, Longview, WA 98632 | 2019-11-05 |
| 1659913358 | Justin David Curran | Physician Assistant | 1230 7th Ave, Longview, WA 98632-3166 | 2019-10-14 |
| 1669026803 | Autumn Leigh Neuenschwander | Social Worker | 1230 7th Ave, Longview, WA 98632-3166 | 2019-07-25 |
| 1609428267 | Sarah Burnett Keller | Social Worker | 1230 7th Ave, Longview, WA 98632-3166 | 2019-07-14 |
| 1598248601 | Matthew Elyea | Physician Assistant | 1230 7th Ave, Longview, WA 98632-3166 | 2018-09-13 |
| 1265926026 | Ellie Renae Hultgren | Physician Assistant | 1230 7th Ave, Longview, WA 98632-3166 | 2018-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023678240 | Washington Institute for Coagulation | Pharmacy | 921 Terry Ave Ste A, Seattle, WA 98104-1239 | 2019-06-19 |
| 1093274458 | Ksr Health Care LLC | Pharmacy | 507 Stevens Avenue, Suite Aaa, Sultan, WA 98294 | 2019-03-15 |
| 1184171704 | Pharmacy Corporation of America | Pharmacy | 18110 Se 34th St Bldg 2, Vancouver, WA 98683-9440 | 2016-09-01 |
| 1770995722 | Healthpoint | Pharmacy | 13030 Military Rd S Ste 206, Tukwila, WA 98168-3080 | 2014-05-27 |
| 1447678875 | Community Health Center of Snohomish County | Pharmacy | 23300 Highway 99, Edmonds, WA 98026-8744 | 2014-04-02 |
| 1982025128 | Seattle Cancer Care Alliance | Pharmacy | 1560 N 115th St Ste G-16a, Seattle, WA 98133-8414 | 2013-12-13 |
| 1598190597 | Sea Mar Community Health Centers | Pharmacy | 1920 100th St Se Ste B, Everett, WA 98208-3832 | 2013-09-09 |
| 1326472234 | Lourdes West Pasco Pharmacy | Pharmacy | 7425 Wrigley Dr Ste 104, Pasco, WA 99301-5292 | 2013-08-27 |
| 1386089761 | Unity Care Northwest | Pharmacy | 218 Unity St, Bellingham, WA 98225-4420 | 2013-04-30 |
| 1619205267 | Puget Sound Pharmacy LLC | Pharmacy | 1112 6th Ave Ste 101, Tacoma, WA 98405-4048 | 2009-11-19 |
| Find all providers with the same taxonomy | ||||
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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.