NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of the Northwest

  • Long Term Care Pharmacy
  • Portland, OR
National Provider Identifier
1215976014
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
RP00002128-CS Issued in OR
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Practice address
5717 NE 138TH Ave
Portland, OR 97230-3409
Phone
(503) 261-7927
Fax
(503) 261-2015
NPI assigned
Jun 6, 2006
Organization subpart
No

National Provider Directory

National Provider Directory
Tax ID family
Permananet Clinic150 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Authorized official

Name
Alfred Lyman, PHARMD, BCPS
Title
Executive Director, Regional Pharma
Phone
(800) 813-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X RP00002128-CS OR Primary
Long Term Care Pharmacy 3336L0003X PHNR.FO.00058658 WA

Addresses

Primary practice location

5717 NE 138TH Ave
Portland, OR 97230-3409

Mailing address

5717 NE 138TH Ave
Portland, OR 97230
Phone (503) 261-7927

Other identifiers 3

IdentifierTypeStateIssuer
2079265OtherPK
230431MedicaidOR
6028047MedicaidWA

Other names 1

  • KAISER PERMANENTE COMMUNITY CARE 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)

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1215976014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 NE 138TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97230",
            "telephone_number": "503-261-7927",
            "fax_number": "503-261-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 NE 138TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972303409",
            "telephone_number": "503-261-7927",
            "fax_number": "503-261-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "LYMAN",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, REGIONAL PHARMA",
        "authorized_official_telephone_number": "800-813-2000",
        "authorized_official_credential": "PHARMD, BCPS"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OR",
            "license": "RP00002128-CS",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WA",
            "license": "PHNR.FO.00058658",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2079265",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230431",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6028047",
            "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": "5717 NE 138th Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972303409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "KAISER PERMANENTE COMMUNITY CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KAISER PERMANENTE COMMUNITY CARE 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 1, 2021; 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.