COLUMBIAN LUTHERAN CHARITIES NPI 1588090393

NPI Information

  • NPI: 1588090393
  • Provider Name: COLUMBIAN LUTHERAN CHARITIES
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Doing Business As: CMH PRIMARY CARE CLINIC
  • Address: 1639 SE ENSIGN LN
    SUITE B103
    WARRENTON, OR
    ZIP 97146
  • Phone: (503) 338-4500

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NPI Details

COLUMBIAN LUTHERAN CHARITIES is a clinic center in Warrenton, OR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). COLUMBIAN LUTHERAN CHARITIES NPI is 1588090393. The provider is registered as an organization entity type.
The provider Is Doing Business As Cmh Primary Care Clinic.

The provider's business location address is:

1639 SE ENSIGN LN
SUITE B103
WARRENTON, OR
ZIP 97146-308
Phone: (503) 338-4500
Fax: (503) 338-4501

The provider's authorized official is Kenneth Boucher .
The authorized official title is Coo and has the following contact phone number (503) 338-5763.

The enumeration date for this NPI number is 9/25/2013 and was last updated on 9/25/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

What is NPI?

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This page was last updated on: 11/21/2025

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