KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1659823896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659823896 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | BROOKSIDE CENTER |
| Practice Address |
10180 Se Sunnyside Rd Clackamas OR 97015-8970 |
| Mailing Address |
500 Ne Multnomah St Portland OR 97232-2023 |
| Practice Telephone | 8008132000 |
| Practice Fax Number | 5032866879 |
| Mailing Telephone | 8008132000 |
| Mailing Fax Number | 5032866879 |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2016-11-03 |
| 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 |
|---|---|
| Brookside Center | 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 |
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 | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720530058 | Kaiser Foundation Health Plan of The Northwest | General Practice | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-11-03 |
| 1831641158 | Kaiser Foundation Health Plan of The Northwest | General Practice | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2016-11-03 |
| 1255882320 | Kaiser Foundation Health Plan of The Northwest | General Practice | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2016-10-24 |
| 1336690403 | Kaiser Foundation Health Plan of The Northwest | General Practice | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5743 | 2016-10-24 |
| 1164973236 | Kaiser Foundation Health Plan of The Northwest | General Practice | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2016-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234674 | Sme Hawaii PC Inc | General Practice | 6021 Se Heike St, Hillsboro, OR 97123-8296 | 2020-10-27 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1346751443 | Providence Health & Services Oregon | General Practice | 4400 Ne Halsey St, Pop 2, 3rd Floor, Portland, OR 97213-1545 | 2017-10-16 |
| 1801333901 | Kaiser Foundation Health Plan of The Northwest | General Practice | 3175 Nw Aloclek Dr, Hillsboro, OR 97124-7135 | 2017-01-26 |
| 1336697143 | Rita Lawler | General Practice | 8353 Se Clatsop Ct, Portland, OR 97266-6159 | 2016-09-21 |
| 1821541939 | Samuel R. Sabo | General Practice | 18171 Waldow Rd., Oregon City, OR 97045 | 2016-07-26 |
| 1659730760 | Propel Network, LLC | General Practice | 14525 Sw Millikan Way, Beaverton, OR 97005-2343 | 2016-02-17 |
| 1235526849 | Hollis Lule Augee | General Practice | 5151 S.w. 88th Ave., Portland, OR 97225-1717 | 2015-04-21 |
| 1023428034 | Victoria L. Larson | General Practice | 10,000 Se 222nd Ave., Damascus, OR 97089-6517 | 2014-04-29 |
| 1093134496 | Red Leaf Natural Health Clinic | General Practice | 833 Sw 11th Ave Ste 1018, Portland, OR 97205-2124 | 2014-04-14 |
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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.