Organization
CG GROUP ASTORIA MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W LARY (ADMINISTRATOR)
(503) 861-6244
Entity
Organization
Contact information
Practice address
2185 SE 12TH PL, WARRENTON, OR 97146-9311
(503) 861-6240
(503) 861-6358
Mailing address
2185 SE 12TH PL, WARRENTON, OR 97146-9311
(503) 861-6240
(503) 861-6358
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
207QA0505X
Adult Medicine Physician
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/18/2006
Last updated
09/11/2025
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