NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of Washington

Doing business as Kaiser Permanente Northshore Pharmacy

  • Pharmacy
  • Bothell, WA
National Provider Identifier
1730213711
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
CF00002310 Issued in WA
Legal business name
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Doing business as
Kaiser Permanente Northshore Pharmacy
Practice address
11913 NE 195TH St
Bothell, WA 98011-3147
Phone
(425) 489-3111
Fax
(425) 489-3119
NPI assigned
Mar 14, 2007
Last updated
Jan 29, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
KAISER FOUNDATION HEALTH PLAN OF WASHINGTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Gail Ann ElliottNPI 1588965529
Title
Program MGR, RX Regulatory
Phone
(206) 630-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X CF00002310 WA Primary
Clinic Pharmacy 3336C0002X CF00002310 WA

Addresses

Primary practice location

11913 NE 195TH St
Bothell, WA 98011-3147

Mailing address

2921 Naches Ave SW
Rca-B1N-04
Renton, WA 98057
Phone (206) 630-2222

Other identifiers 1

IdentifierTypeStateIssuer
4916221OtherWANCPDP

Other names 1

  • Kaiser Permanente Northshore Pharmacy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000454 WA Part B Supplier - Clinic/Group Practice 9032022579 Receives reassigned benefits from 3,062 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Kaiser Foundation HP of Wa

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1730213711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 NACHES AVE SW",
            "address_2": "RCA-B1N-04",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98057",
            "telephone_number": "206-630-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11913 NE 195TH ST",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113147",
            "telephone_number": "425-489-3111",
            "fax_number": "425-489-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF WASHINGTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAISER FOUNDATION HEALTH PLAN OF WASHINGTON",
        "enumeration_date": "2007-03-14",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROGRAM MGR, RX REGULATORY",
        "authorized_official_telephone_number": "206-630-2222"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WA",
            "license": "CF00002310",
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WA",
            "license": "CF00002310",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4916221",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11913 NE 195th St",
            "city": "Bothell",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980113147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente Northshore Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.