Provider Demographics
NPI:1720600141
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:PROGRAM MGR, RX REGULATORY
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-630-2222
Mailing Address - Street 1:2921 NACHES AVE SW
Mailing Address - Street 2:RCA-B1N-04
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057
Mailing Address - Country:US
Mailing Address - Phone:206-630-2222
Mailing Address - Fax:
Practice Address - Street 1:700 LILLY RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5115
Practice Address - Country:US
Practice Address - Phone:360-923-7600
Practice Address - Fax:360-923-7609
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-07
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy