NPIMap

Organization Active NPI

Kaiser Permanente

  • Preferred Provider Organization
  • Longview, WA
National Provider Identifier
1689776916
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
CP00002701 Issued in WA
Legal business name
KAISER PERMANENTE
Practice address
1230 7TH Ave
Longview, WA 98632-3166
Phone
(360) 636-6235
Fax
(360) 575-4805
NPI assigned
Sep 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Donna Rae Yeager, M.ED./CDP
Title
Addiction Medicine Therapist
Phone
(360) 636-6294

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X CP00002701 WA Primary

Addresses

Primary practice location

1230 7TH Ave
Longview, WA 98632-3166

Mailing address

125 Nectarine Drive
Kalama, WA 98625
Phone (360) 673-3434

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689776916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 NECTARINE DRIVE",
            "city": "KALAMA",
            "state": "WA",
            "postal_code": "98625",
            "telephone_number": "360-673-3434",
            "fax_number": "360-575-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 7TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323166",
            "telephone_number": "360-636-6235",
            "fax_number": "360-575-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YEAGER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "ADDICTION MEDICINE THERAPIST",
        "authorized_official_telephone_number": "360-636-6294",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED./CDP"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "CP00002701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.