NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of the Northwest

  • Clinic Pharmacy
  • Vancouver, WA
National Provider Identifier
1386682946
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
00005461 Issued in WA
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Doing business as
Kaiser Permanente Salmon Creek Pharmacy
Practice address
14406 NE 20TH Ave
Vancouver, WA 98686-1448
Phone
(360) 571-3072
Fax
(360) 571-3095
NPI assigned
Jun 3, 2006
Organization subpart
No

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X 00005461 WA Primary
Community/Retail Pharmacy 3336C0003X
Managed Care Organization Pharmacy 3336M0003X

Addresses

Primary practice location

14406 NE 20TH Ave
Vancouver, WA 98686-1448

Mailing address

5725 NE 138TH Ave
Portland, OR 97230-3409
Phone (503) 261-7980

Other identifiers 3

IdentifierTypeStateIssuer
138144MedicaidOR
2110346OtherPK
6019525MedicaidWA

Other names 1

  • Kaiser Permanente Salmon Creek 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
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

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1386682946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 NE 138TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972303409",
            "telephone_number": "503-261-7980",
            "fax_number": "503-261-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14406 NE 20TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861448",
            "telephone_number": "360-571-3072",
            "fax_number": "360-571-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WA",
            "license": "00005461",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138144",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2110346",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6019525",
            "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": "14406 NE 20th Ave",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986861448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente Salmon Creek Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Permanente Salmon Creek Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.