NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of the Northwest

  • Clinic Pharmacy
  • Longview, WA
National Provider Identifier
1790113371
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
PHAR.CF.60362983 Issued in WA
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Doing business as
Kaiser Permanente Longview Kelso Oncology Pharmacy
Practice address
1230 7TH Ave.
Longview, WA 98682
Phone
(866) 279-8943
Fax
(360) 636-6271
NPI assigned
Oct 17, 2013
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
Steve Logan, RPH
Title
Exec. Director Pharmacy Services
Phone
(503) 261-7566

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X PHAR.CF.60362983 WA Primary
Managed Care Organization Pharmacy 3336M0003X

Addresses

Primary practice location

1230 7TH Ave.
Longview, WA 98682

Mailing address

5725 NE 138TH Ave.
Portland, OR 97230-3409
Phone (503) 261-2166

Other identifiers 2

IdentifierTypeStateIssuer
6019384MedicaidWA
PHAR.CF.60362983WAOtherWABOP LICENSE

Other names 1

  • Kaiser Permanente Longview Kelso Oncology 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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1790113371",
    "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": "503-261-2166",
            "fax_number": "503-261-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 7TH AVE.",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98682",
            "telephone_number": "866-279-8943",
            "fax_number": "360-636-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-17",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "EXEC. DIRECTOR PHARMACY SERVICES",
        "authorized_official_telephone_number": "503-261-7566",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.60362983",
            "primary": true
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6019384",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOP LICENSE",
            "identifier": "PHAR.CF.60362983WA",
            "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": "1230 7th Ave.",
            "city": "Longview",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente Longview Kelso Oncology Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Permanente Longview Kelso Oncology Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.