NPIMap

Organization Active NPI

Columbian Lutheran Charities

Doing business as CMH Primary Care Clinic

  • Clinic/Center
  • Warrenton, OR
National Provider Identifier
1588090393
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COLUMBIAN LUTHERAN CHARITIES
Doing business as
CMH Primary Care Clinic
Practice address
1639 SE Ensign LN
Suite B103
Warrenton, OR 97146-7308
Phone
(503) 338-4500
Fax
(503) 338-4501
NPI assigned
Sep 25, 2013
Last updated
Sep 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenneth Boucher
Title
Coo
Phone
(503) 338-5763

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1639 SE Ensign LN
Suite B103
Warrenton, OR 97146-7308

Mailing address

2111 Exchange St
Astoria, OR 97103-3329
Phone (503) 338-4500

Other names 1

  • CMH Primary Care Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Columbia Lutheran Charities13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1639 SE Ensign Ln
Ste B103
Warrenton, OR 97146
Phone (503) 338-4500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1588090393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 EXCHANGE ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033329",
            "telephone_number": "503-338-4500",
            "fax_number": "503-338-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 SE ENSIGN LN",
            "address_2": "SUITE B103",
            "city": "WARRENTON",
            "state": "OR",
            "postal_code": "971467308",
            "telephone_number": "503-338-4500",
            "fax_number": "503-338-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIAN LUTHERAN CHARITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "BOUCHER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "503-338-5763"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMH Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warrenton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.