KAISER FOUNDATION HEALTH PLAN NORTHWEST (NPI# 1528002474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528002474 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN NORTHWEST |
| Other Organization Name | KAISER SUNNYSIDE OUTPATIENT PHARMACY |
| Practice Address |
10180 Se Sunnyside Rd Clackamas OR 97015-8970 |
| Practice Telephone | 5035714222 |
| Practice Fax Number | 5035714166 |
| Mailing Telephone | 5035714222 |
| Mailing Fax Number | 5035714166 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JIM DUNSCOMB (SUPERVISOR) |
| Authorized Official Telephone | 5035712022 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
00650 | OR | Suppliers |
| X | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
00650 | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 6019343 | 05 | |
| OR | NCPDP | 3811848 | 01 |
| OR | 136742 | 05 |
| Other Name | Type Code |
|---|---|
| Kaiser Sunnyside Outpatient Pharmacy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568418069 | Kaiser Foundation Health Plan Northwest | Pharmacy | 16703 Se Mcgillivray Blvd, Vancouver, WA 98683-4300 | 2006-05-26 |
| 1851880199 | Kaiser Foundation Health Plan Northwest | Dentist | 2930 Ne Dekum St, Portland, OR 97211-6613 | 2018-05-02 |
| 1073030730 | Kaiser Foundation Health Plan Northwest | Registered Nurse | 2930 Ne Dekum St, Portland, OR 97211-6613 | 2017-08-24 |
| Street Address |
10180 SE SUNNYSIDE RD |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-8970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407855786 | Kevin C La Cour | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2005-07-19 |
| 1588270466 | Jacob Aaron Stutheit | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-09-16 |
| 1023633005 | Jeremy Ward | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-06-15 |
| 1336761998 | Maksim Ivan Yablonsky | Technician, Other | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-05-17 |
| 1497389811 | Clifford Andrew Moore | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-25 |
| 1417580622 | Taryn Dee | Surgery | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-16 |
| 1881225241 | Jocelyn Mason | Pharmacist | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-03 |
| 1760022461 | Katie Keim | Social Worker | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-01-09 |
| 1346887668 | Hannah N. Schroeder | Registered Nurse | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-12-05 |
| 1164072286 | Thien-huong Theresa Van | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 3336M0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Managed Care Organization Pharmacy |
| A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO’s covered members only. |
| 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 |
|---|---|---|---|---|
| 1467511832 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2006-12-08 |
| 1407893407 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-05-31 |
| 1881641926 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093142234 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 1700 Ne 102nd Ave., Portland, OR 97220 | 2013-10-02 |
| 1760564561 | Prostar Pharmacy Consultants LLC | Pharmacy | 91320 Coburg Industrial Way, Bldg 19, Coburg, OR 97408 | 2006-10-20 |
| 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 |
| 1124462940 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 2875 Nw Stucki Ave, Hillsboro, OR 97124-5806 | 2013-04-23 |
| 1972736932 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 11200 Sw Murray Scholls Pl, Beaverton, OR 97007-9702 | 2009-08-25 |
| 1467491886 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2006-06-05 |
| 1699714063 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 19185 Sw 90th Ave, Tualatin, OR 97062-7558 | 2006-06-04 |
| 1306883301 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 19500 Se Stark St, Portland, OR 97233-5757 | 2006-05-31 |
Please comment or provide details below to improve the information on KAISER FOUNDATION HEALTH PLAN NORTHWEST.
| 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.