1801230529 NPI number — KAISER FOUNDATION HOSPITALS

Table of content: (NPI 1801230529)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801230529 NPI number — KAISER FOUNDATION HOSPITALS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAISER FOUNDATION HOSPITALS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KAISER PERMANENTE WESTSIDE INPATIENT PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801230529
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5725 NE 138TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97230-3409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
971-310-4050
Provider Business Mailing Address Fax Number:
971-310-4061

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2875 NW STUCKI AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HILLSBORO
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97124-5806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
971-310-4050
Provider Business Practice Location Address Fax Number:
971-310-4061
Provider Enumeration Date:
04/24/2013

Additional Information

Authorized Official

Authorized Official Last Name:
LYMAN
Authorized Official First Name:
ALFRED
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
EXEC. DIRECTOR PHARMACY SERVICES
Authorized Official Telephone Number:
503-261-7566

Provider Taxonomy Codes

  • Taxonomy code: 3336I0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RP-0002783-CS . This is a "BOP LICENSE" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




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