KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1609043116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609043116 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | KAISER PERMANENTE WEST SALEM PHARMACY |
| Practice Address |
1160 Wallace Rd Nw Salem OR 97304-3116 |
| Practice Telephone | 8665250583 |
| Practice Fax Number | 5033184038 |
| Mailing Telephone | 8665250583 |
| Mailing Fax Number | 5033184038 |
| Enumeration Date | 2008-05-14 |
| 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 | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
RP-0002473-CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2079586 | 01 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente West Salem 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 |
1160 WALLACE RD NW |
| City | SALEM |
| State | OR |
| Zip Code | 97304-3116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760450308 | Barbara G C Hoover | Family Medicine | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2006-03-09 |
| 1235789298 | Dorian Truong | Physician Assistant | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2019-09-11 |
| 1306398250 | Kaiser Foundation Health Plan of The Northwest | General Practice | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2016-10-26 |
| 1003235474 | Bethany Wohletz | Family Medicine | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2014-04-14 |
| 1174768576 | Tatiana O Anderson | Pharmacist | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2008-12-14 |
| 1598919565 | Kaiser Foundation Health Plan of The Northwest | Clinical Medical Laboratory | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2008-11-04 |
| 1437306578 | Kaiser Foundation Health Plan of The Northwest | Clinic/Center | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2008-08-20 |
| 1760668636 | Steven R Thorvilson | Pharmacist | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2008-01-10 |
| 1851584700 | Suzanne Marie Deschamps | Family Medicine | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2007-08-23 |
| 1043392012 | Mark Warren Olson | Family Medicine | 1160 Wallace Rd Nw, Salem, OR 97304-3116 | 2006-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114413010 | Sam Mackenzie Lane | Massage Therapist | 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 | 2018-07-03 |
| 1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
| 1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
| 1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
| 1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
| 1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
| 1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
| 1336401017 | Trillium Family Services | Community/Behavioral Health | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2012-06-08 |
| 1033428198 | Kathleen Ketelson | Nurse Practitioner | 560 Wallace Rd Nw Ste 140, Salem, OR 97304 | 2010-10-06 |
| 1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
| Find all providers in zip 97304 | ||||
| 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 |
|---|---|---|---|---|
| 1801834510 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 2400 Lancaster Dr Ne, Salem, OR 97305-1221 | 2006-06-03 |
| 1467491886 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2006-06-05 |
| 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 |
| 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 |
| 1467511832 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2006-12-08 |
| 1528002474 | Kaiser Foundation Health Plan Northwest | Pharmacy | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-06-15 |
| 1699714063 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 19185 Sw 90th Ave, Tualatin, OR 97062-7558 | 2006-06-04 |
| 1407893407 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-05-31 |
| 1306883301 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 19500 Se Stark St, Portland, OR 97233-5757 | 2006-05-31 |
| 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.