Organization
COLUMBIAN LUTHERAN CHARITIES
Active
Other names
CMH Primary Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH BOUCHER (COO)
(503) 338-5763
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
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/25/2013
Last updated
09/25/2013
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