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KAISER FOUNDATION HEALTH PLAN NORTHWEST NPI 1073030730


NPI Information

NPI: 1073030730
Provider Name: KAISER FOUNDATION HEALTH PLAN NORTHWEST

Other Name: KAISER PERMANENTE 3 TO PHD WELLNESS CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
2930 NE DEKUM ST
PORTLAND, OR
ZIP 97211
Phone: (800) 813-2000
Get Directions

KAISER FOUNDATION HEALTH PLAN NORTHWEST is a family medicine in Portland, OR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. KAISER FOUNDATION HEALTH PLAN NORTHWEST NPI is 1073030730. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Kaiser Permanente 3 To Phd Wellness Center.

The provider's business location address is:

2930 NE DEKUM ST
PORTLAND, OR
ZIP 97211-613
Phone: (800) 813-2000
Fax: (503) 286-6879

The provider's authorized official is Stephen Shawn Barton .
The authorized official title is Executive Director, Revenue Cycle and has the following contact phone number (503) 813-2440.

The enumeration date for this NPI number is 8/24/2017 and was last updated on 6/1/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1163W00000XRegistered NurseNo
2207Q00000XFamily MedicineYes
3207R00000XInternal MedicineNo
4363A00000XPhysician AssistantNo
5363L00000XNurse PractitionerNo
6364S00000XClinical Nurse SpecialistNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1147090MEDICAIDOREGON
27857501MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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