NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of the Northwest

Doing business as Kaiser Permanente East Interstate Pharmacy

  • Managed Care Organization Pharmacy
  • Portland, OR
National Provider Identifier
1013963131
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Managed Care Organization PharmacyTaxonomy code 3336M0003X
License
RP-0000717-CS Issued in OR
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Doing business as
Kaiser Permanente East Interstate Pharmacy
Practice address
3550 N Interstate Ave
Portland, OR 97227-1196
Phone
(866) 279-6122
Fax
(503) 249-3438
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephen Shawn Barton
Title
Executive Director, Revenue Cycle
Phone
(800) 813-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X
Managed Care Organization Pharmacy 3336M0003X RP-0000717-CS OR Primary

Addresses

Primary practice location

3550 N Interstate Ave
Portland, OR 97227-1196

Mailing address

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (866) 279-6122

Other identifiers 3

IdentifierTypeStateIssuer
136650MedicaidOR
2077391OtherPK
6019418MedicaidWA

Other names 1

  • Kaiser Permanente East Interstate Pharmacy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Permanent150 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1013963131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 N INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271196",
            "telephone_number": "866-279-6122",
            "fax_number": "503-249-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 N INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271196",
            "telephone_number": "866-279-6122",
            "fax_number": "503-249-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "800-813-2000"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "OR",
            "license": "RP-0000717-CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136650",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2077391",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6019418",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3550 N Interstate Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972271196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente East Interstate Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Permanente East Interstate Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.