Provider Demographics
NPI:1912530106
Name:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Entity Type:Organization
Organization Name:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Other - Org Name:KAISER PERMANENTE CENTRAL HOME INFUSION PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-630-2504
Mailing Address - Street 1:1300 SW 27TH STREET
Mailing Address - Street 2:RCG-D2W-06
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-9055
Mailing Address - Country:US
Mailing Address - Phone:206-630-1029
Mailing Address - Fax:206-630-1025
Practice Address - Street 1:201 16TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5226
Practice Address - Country:US
Practice Address - Phone:205-326-2990
Practice Address - Fax:206-326-2139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAISER FOUNDATION HEALTH PLAN OF WA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-17
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy