Provider Demographics
NPI:1285805119
Name:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Entity type:Organization
Organization Name:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-241-7343
Mailing Address - Street 1:PO BOX 34584
Mailing Address - Street 2:
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:
Practice Address - Street 1:2921 NACHES AVE SW
Practice Address - Street 2:GSE-B2E-01
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2617
Practice Address - Country:US
Practice Address - Phone:206-630-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-19
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMTS-0697291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
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