Provider Demographics
NPI:1528198660
Name:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Entity Type:Organization
Organization Name:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Other - Org Name:GROUP HEALTH HOME HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-630-1818
Mailing Address - Street 1:201 16TH AVE E
Mailing Address - Street 2:CMB- C140
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5226
Mailing Address - Country:US
Mailing Address - Phone:206-326-4530
Mailing Address - Fax:206-326-4555
Practice Address - Street 1:201 16TH AVE E
Practice Address - Street 2:CMB-C140
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5226
Practice Address - Country:US
Practice Address - Phone:206-326-4530
Practice Address - Fax:206-326-4555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GROUP HEALTH COOPERATIVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-07
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA478001461251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA011283OtherFACILITY - HOME HEALTH
WA011283OtherFACILITY - HOME HEALTH