KAISER FOUNDATION HEALTH PLAN OF WASHINGTON

Provider Demographics

• NPI: 1396810701
• Name: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• Entity type: Organization
• Organization Name: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• Authorized Official - Title/Position: MANAGER
• Authorized Official - First Name: MICHELLE
• Authorized Official - Last Name: BARLOW
• Authorized Official - Phone: 509-241-7343
• Mailing Address - Street 1: PO BOX 34584
• Mailing Address - City: SEATTLE
• Mailing Address - State: WA
• Mailing Address - Zip Code: 98124-1584
• Mailing Address - Country: US
• Mailing Address - Phone: 509-241-7349
• Mailing Address - Fax: 509-241-7628
• Practice Address - Street 1: 320 WESTLAKE AVE. N.
• Practice Address - Street 2: SUITE 100
• Practice Address - City: SEATTLE
• Practice Address - State: WA
• Practice Address - Zip Code: 98109-5233
• Practice Address - Country: US
• Practice Address - Phone: 206-448-6561
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-11-21
• Last Update Date: 2021-07-06

Provider Licenses

State	License ID	Taxonomies
WA	478001461	261QM1300X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	261QM1300X	Ambulatory Health Care Facilities	Clinic/Center	Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
WA	8020794	Medicaid
ID	003261700	Medicaid
WA	DB8554	Medicare PIN
WA	G001050800	Medicare PIN
WA	GAB29652	Medicare PIN
WA	GAB32522	Medicare PIN
WA	8020794	Medicaid
WA	DB6523	Medicare PIN
WA	CG4666	Medicare PIN
WA	500052	Medicare Oscar/Certification
WA	CR0091	Medicare PIN
WA	DA7704	Medicare PIN
WA	DC0146	Medicare PIN
WA	GAB32817	Medicare PIN
WA	GAB35362	Medicare PIN
WA	CK3568	Medicare PIN
WA	DC1330	Medicare PIN
WA	GAB32846	Medicare PIN
ID	003261700	Medicaid
WA	DB7688	Medicare PIN
WA	G001046100	Medicare PIN
WA	G001247800	Medicare PIN
WA	GAB35602	Medicare PIN
ID	1371912	Medicare PIN
WA	DB1637	Medicare PIN
WA	GAB32507	Medicare PIN
WA	GAB32593	Medicare PIN
ID	1594000	Medicare PIN
WA	CK4114	Medicare PIN
WA	DB6754	Medicare PIN
WA	DB8553	Medicare PIN
WA	DC1326	Medicare PIN
WA	GAB35679	Medicare PIN
WA	DB6411	Medicare PIN
WA	DC0317	Medicare PIN
WA	G000135000	Medicare PIN
WA	G000245400	Medicare PIN
WA	GAB32527	Medicare PIN