NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Northwest

  • Clinic Pharmacy
  • Vancouver, WA
National Provider Identifier
1568418069
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
05462 Issued in WA
Legal business name
KAISER FOUNDATION HEALTH PLAN NORTHWEST
Practice address
16703 SE McGillivray Blvd
Vancouver, WA 98683-4300
Phone
(360) 735-5645
Fax
(360) 735-5646
NPI assigned
May 26, 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
Joyce Humphrey, R.PH.
Title
Supervisor
Phone
(360) 735-5274

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 05462 WA Primary
Managed Care Organization Pharmacy 3336M0003X 05462 WA

Addresses

Primary practice location

16703 SE McGillivray Blvd
Vancouver, WA 98683-4300

Mailing address

16703 SE McGillivray Blvd
Vancouver, WA 98683-4300
Phone (360) 735-5645

Other identifiers 3

IdentifierTypeStateIssuer
6019483MedicaidWA
4925383OtherWANCPDP
138151MedicaidOR

Other names 1

  • Kaiser Fisher's Landing Pharmacy Other name

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

Locations

16703 SE McGillivray Blvd
Vancouver, WA 98683
Phone (360) 735-5641

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": "1622505600000",
    "number": "1568418069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16703 SE MCGILLIVRAY BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834300",
            "telephone_number": "360-735-5645",
            "fax_number": "360-735-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16703 SE MCGILLIVRAY BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834300",
            "telephone_number": "360-735-5645",
            "fax_number": "360-735-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "HUMPHREY",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "360-735-5274",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WA",
            "license": "05462",
            "primary": true
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "WA",
            "license": "05462",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6019483",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4925383",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138151",
            "state": "OR"
        }
    ],
    "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": "16703 SE McGillivray Blvd",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986834300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Fisher's Landing Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Kaiser Fisher's Landing Pharmacy",
            "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 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.