Provider Demographics
NPI:1518589936
Name:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Entity Type:Organization
Organization Name:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Other - Org Name:KAISER PERMANENTE TACOMA INFUSION PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-630-2504
Mailing Address - Street 1:1300 SW 27TH
Mailing Address - Street 2:RCG-D2W-06
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057
Mailing Address - Country:US
Mailing Address - Phone:206-630-1029
Mailing Address - Fax:206-630-1025
Practice Address - Street 1:209 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4265
Practice Address - Country:US
Practice Address - Phone:253-596-3350
Practice Address - Fax:253-596-3351
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-07
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy