OrganizationActive
Kaiser Foundation Health Plan of the Northwest
NPI 1104378140 · General Practice Physician · Portland, OR
Provider details
- NPI number
- 1104378140
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Kaiser Foundation Health Plan of the Northwest
- Organization subpart
- Yes
- Authorized official
- Stephen Barton, Executive Director, Revenue Cycle(503) 813-2440
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Optometrist152W00000X
Eye and Vision Services Providers
- Technician/Technologist156F00000X
Eye and Vision Services Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12100 Se Stevens Ct
Suite 106
Portland, OR 97086-4707
Phone: (800) 813-2000
Fax: (503) 286-6879
Street-level locationGet directions
Mailing address
500 Ne Multnomah St
Portland, OR 97232-2023
Other names (DBA / former)
- Other name
- Clackamas Eye Care
- Other name
- Clackamas Eye Care
Registry dates
- Enumerated
- 2016-10-25
- Last updated
- 2021-06-01
- Certified
- 2021-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.