KAISER PERMANENTE CENTRAL INTERSTATE PHARMACY
NPI 1407803513
Pharmacy - Clinic Pharmacy in Portland, OR

Q: What is Kaiser Foundation Health Plan Of The Northwest's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Clinic Pharmacy, with taxonomy code 3336C0002X.

Active since May 27, 2006

3600 N INTERSTATE AVE, PORTLAND, OR 97227(503) 331-6570(503) 331-6575 Get Directions Write a Review

NPPES record last updated: June 1, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 1, 2021, Jul 19, 2018, Apr 18, 2018 and 4 more (7 updates tracked since 2016).

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About Kaiser Permanente Central Interstate Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAISER PERMANENTE CENTRAL INTERSTATE PHARMACY (NPI 1407803513) is a healthcare organization registered as a clinic pharmacy in Portland, Oregon and active in the NPI registry since May 2006. The organization lists Alfred Lyman, Executive Director, Regional Pharma, as its authorized official.

NPPES Registry Identity

NPI1407803513

Entity TypeOrganization

Primary Taxonomy3336C0002X

Legal Business NameKAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST

Location Address3600 N INTERSTATE AVEPortland, OR 97227-1106

Mailing Address3600 N Interstate AvePortland, OR 97227-1106 · (503) 331-6570 · Fax (503) 331-6575

Phone(503) 331-6570

Fax(503) 331-6575

Organization SubpartNo

Authorized OfficialAlfred LymanExecutive Director, Regional Pharma · (800) 813-2000

Enumeration DateMay 27, 2006

Last NPPES UpdateJune 1, 20217 updates tracked since enumeration

NPPES CertifiedJune 1, 2021

✔ NPI 1407803513 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Clinic PharmacySuppliers

Taxonomy Code3336C0002X

License✔ Licensed in OR · RP-0001284-CS

Definition

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

Also ListedPharmacyTaxonomy 333600000X · License PHNR.FO.60658960 (WA)

Also ListedPharmacy · Managed Care Organization PharmacyTaxonomy 3336M0003X

3600 N INTERSTATE AVE, Portland, OR 97227

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Other Names 1

Doing Business AsKaiser Permanente Central Interstate Pharmacy

Other Identifiers 3

Medicaid6019434WA

Medicaid136635OR

Other2078433Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID WEI KUO LIN M.D.

Otolaryngology

3600 N INTERSTATE AVE, INTERSTATE MEDICAL OFFICE CENTRAL
PORTLAND, OR 97227

Multnomah County (503) 331-6085

DR. LYNETTE SANTOS MALIK M.D.

Physical Medicine & Rehabilitation (Sports Medicine)

3600 N INTERSTATE AVE, DEPARTMENT OF PHYSICAL MEDICINE
PORTLAND, OR 97227

Multnomah County (503) 331-3070

DR. RYO A. SHOHARA M.D.

Internal Medicine (Hematology & Oncology)