NPIMap

Organization Active NPI

Columbia Lutheran Charities

Doing business as Columbia Memorial Hospital

  • Surgery Physician
  • Astoria, OR
National Provider Identifier
1821254129
Registry record updated Sep 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
141146 Issued in OR
Legal business name
COLUMBIA LUTHERAN CHARITIES
Doing business as
Columbia Memorial Hospital
Practice address
2111 Exchange St
Astoria, OR 97103-3329
Phone
(503) 325-4321
NPI assigned
Aug 6, 2008
Last updated
Sep 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2017

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

Authorized official

Name
Erik W Thorsen
Title
Ceo
Phone
(503) 338-7505

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X NU
Critical Access Hospital Clinic/Center 261QC0050X 141146 OR
Cardiovascular Disease Physician 207RC0000X 141146 OR
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 14-1146 OR
Hematology & Oncology Physician 207RH0003X 14-1146 OR
Pulmonary Disease Physician 207RP1001X 14-1146 OR
Obstetrics & Gynecology Physician 207V00000X 141146 OR
Orthopaedic Surgery Physician 207X00000X 141146 OR
Otolaryngology Physician 207Y00000X 141146 OR
Pediatrics Physician 208000000X 141146 OR
Surgery Physician 208600000X 141146 OR Primary
Urology Physician 208800000X 141146 OR
General Practice Physician 208D00000X 14-1146 OR

Addresses

Primary practice location

2111 Exchange St
Astoria, OR 97103-3329

Mailing address

2111 Exchange St
Astoria, OR 97103-3329
Phone (503) 325-4321

Other identifiers 1

IdentifierTypeStateIssuer
500621984MedicaidOR

Other names 2

  • Columbia Memorial Hospital Doing business as
  • Columbia Lutheran Charities Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20021217000028 OR Part A Provider - Critical Access Hospital 5294643359 Receives reassigned benefits from 299 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Astoria, OR
O20040202000073 OR Part B Supplier - Clinic/Group Practice 5294643359 Receives reassigned benefits from 208 practitioners
5 other NPIs on this enrollment
Practice locations: Warrenton, OR; Astoria, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821254129. Details of each certification follow.

Hospital certification: CCN 381320

Legal name
COLUMBIA LUTHERAN CHARITIES
Doing business as
COLUMBIA MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2005
Last certification
Jan 31, 2006
Beds
49 (25 certified)
Ownership / control type
Private (for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 18, 1958 in OR
Enrollment address
2111 Exchange St
Astoria, OR 97103-3329
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Columbia Memorial HospitalCCN 381320 · All quality measures
Type
Critical Access Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

2095 Exchange St
Ste 201
Astoria, OR 97103
Phone (503) 325-7800

2095 Exchange St
Ste 301
Astoria, OR 97103
Phone (503) 338-4087

2120 Exchange St
Ste 101
Astoria, OR 97103
Phone (503) 338-4560

2158 Exchange St
Ste 107
Astoria, OR 97103
Phone (503) 338-4085

2158 Exchange St
Ste 206
Astoria, OR 97103
Phone (503) 325-4321

2158 Exchange St
Ste 208
Astoria, OR 97103
Phone (503) 468-0127

2158 Exchange St
Ste 302
Astoria, OR 97103
Phone (503) 325-3126

1639 SE Ensign Ln
Ste B102B103
Warrenton, OR 97146
Phone (503) 338-4500

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Paul Haines Individual Corporate DirectorBoard Member Nov 5, 2020 5%
Patricia J Danforth Individual Corporate DirectorBoard Member Dec 1, 2016 5%
Doug Kaup Individual Corporate DirectorBoard Member Dec 1, 2016 5%
Matthew Phillips Individual Corporate DirectorBoard Member Nov 5, 2020 5%
Erik W Thorsen Individual Corporate Officer Mar 2, 2004
W-2 Managing EmployeeCeo Nov 16, 2007 25%
Reanna Thomasson Individual W-2 Managing EmployeePatient Financial Services Manager Nov 9, 2023
Robert L Holland Individual Corporate DirectorBoard Member Dec 5, 2013 5%
David Nygaard Individual Corporate DirectorBoard Member Dec 31, 2016 5%
Constance Carol Waisanen Individual Corporate DirectorBoard Member Mar 5, 2009 5%
Mike Autio Individual Corporate DirectorBoard Member Apr 12, 2018 5%
Mark Smith Individual Corporate DirectorBoard Member Dec 1, 2013 5%
Jeanette Schacher Individual W-2 Managing Employee Dec 18, 2016 5%
Operational/Managerial Control Dec 18, 2016 5%
Quratulain Durrani Individual Corporate DirectorBoard Member Aug 15, 2022 5%
James a Heilman Individual Corporate DirectorBoard Member May 2, 2019 5%
Heather Ann Seppa Individual Corporate DirectorBoard Member Nov 1, 2007 5%
Nancy R McAllister Individual Corporate DirectorBoard Member Apr 23, 1992 5%
William Walter Landwehr Individual Corporate DirectorBoard Member Jan 8, 2009 5%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lower Columbia HospiceAstoria, OR, CCN 381520 Hospice 5% Or Greater Direct Ownership Interest May 22, 1991

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 221

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.

View all 221

Affiliated clinicians 410

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 410

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504742400000",
    "number": "1821254129",
    "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": "503-325-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 EXCHANGE ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033329",
            "telephone_number": "503-325-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA LUTHERAN CHARITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2017-09-07",
        "status": "A",
        "authorized_official_last_name": "THORSEN",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-338-7505"
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "OR",
            "license": "141146",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "141146",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OR",
            "license": "14-1146",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OR",
            "license": "14-1146",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "14-1146",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "141146",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "141146",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "141146",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "141146",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "141146",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "141146",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "14-1146",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500621984",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Columbia Lutheran Charities",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Astoria, OR

Sources for this page

Verify at the official NPI Registry.