Organization
COLUMBIA LUTHERAN CHARITIES
Active
Other names
CMH Primary Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE BRENDEN (CFO)
(503) 325-4321
Entity
Organization
Contact information
Practice address
1639 SE ENSIGN LN, SUITE B103, WARRENTON, OR 97146-7308
(503) 338-4500
(503) 338-4501
Mailing address
2111 EXCHANGE ST, ASTORIA, OR 97103-3329
(503) 338-4500
(503) 338-4501
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
388515
MEDICARE PTAN
OR
Enumeration date
09/11/2012
Last updated
08/06/2015
Update your record
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