Kaiser Foundation Health Plan Of The Northwest
General Practice in Keizer, OR. Organization (NPI-2).
NPI number1629520697
StatusActive
Last updated in NPPESJun 1, 2021
Details
- NPI
- 1629520697
- Entity type
- Organization (NPI-2)
- Legal business name
- Kaiser Foundation Health Plan Of The Northwest
- Organization subpart
- Yes
- Enumeration date
- Oct 26, 2016
- Certification date
- Jun 1, 2021
- Last updated
- Jun 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Other names
- Keizer Station Medical Office (Other Name)
Practice location
5940 Ulali Dr NeKeizer, OR 97303-1500
Phone 800-813-2000 · Fax 503-286-6879
Mailing address
500 Ne Multnomah StPortland, OR 97232-2023
Phone 800-813-2000 · Fax 503-286-6879
Authorized official
Stephen Shawn Barton
Executive Director, Revenue Cycle
5038132440
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