NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Vancouver, WA
National Provider Identifier
1306511878
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Practice address
17700 SE Mill Plain Blvd Ste 190
Vancouver, WA 98683-7582
Phone
(800) 813-2000
NPI assigned
Aug 16, 2021
Organization subpart
Yes
Parent organization
KAISER FOUNDATION HEALTH PLAN NORTHWESTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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
(503) 813-2440

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

17700 SE Mill Plain Blvd Ste 190
Vancouver, WA 98683-7582

Mailing address

500 NE Multnomah St
Portland, OR 97232-2023
Phone (800) 813-2000

Other names 1

  • Columbia Tech KPOJ Other name

Electronic endpoints 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2240066Columbia Tech Kpoj17700 SE Mill Plain Blvd, Vancouver, WA 98683Certificate of waiverApr 4, 2028

National Provider Directory

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

Organizations with this tax ID in the same state 21

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

View all 21

Locations

17700 SE Mill Plain Blvd
Vancouver, WA 98683
Phone (504) 988-2838

17700 SE Mill Plain Blvd
Ste 190
Vancouver, WA 98683
Phone (503) 571-5853

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1306511878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322023",
            "telephone_number": "800-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17700 SE MILL PLAIN BLVD STE 190",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986837582",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAISER FOUNDATION HEALTH PLAN NORTHWEST",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "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": "503-813-2440"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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": "17700 SE Mill Plain Blvd",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986837580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Columbia Tech KPOJ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.