Kaiser Foundation Health Plan Of The Northwest
Dentist in Happy Valley, OR. Organization (NPI-2).
NPI number1629699863
StatusActive
Last updated in NPPESJun 1, 2021
Details
- NPI
- 1629699863
- Entity type
- Organization (NPI-2)
- Legal business name
- Kaiser Foundation Health Plan Of The Northwest
- Organization subpart
- Yes
- Enumeration date
- Apr 28, 2020
- Certification date
- Jun 1, 2021
- Last updated
- Jun 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Other names
- Johnson Creek Dental Office (Doing Business As)
Practice location
9300 Se 91st Ave Ste 310Happy Valley, OR 97086-3762
Phone 800-813-2000
Mailing address
500 Ne Multnomah StPortland, OR 97232-2023
Phone 800-813-2000
Authorized official
Stephen Shawn Barton
Executive Director, Revenue Cycle
5038132440
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