OrganizationActive
Kaiser Foundation Health Plan of the Northwest
NPI 1730108168 · Clinic Pharmacy · Portland, OR
Provider details
- NPI number
- 1730108168
- Entity type
- Organization
- Primary specialty
- Clinic PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Alfred Lyman, Executive Director, Regional Pharma(800) 813-2000
- License
- PHNR.FO.60572833 (WA)
Specialties & taxonomies
Suppliers
Suppliers
- Compounding Pharmacy3336C0004X
Suppliers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
3500 N Interstate Ave
Portland, OR 97227-1196
Phone: (503) 331-6186
Fax: (503) 331-6187
Street-level locationGet directions
Mailing address
5725 Ne 138th Ave
Portland, OR 97230-3409
Other names (DBA / former)
- Doing business as
- Kaiser Permanente Interstate South Pharmacy
- Doing business as
- Kaiser Permanente Interstate South Pharmacy
Registry dates
- Enumerated
- 2006-07-18
- 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.