| Earth Source Medicine | |
|
1490 Commercial St Ste 200 Astoria OR 97103-3800 | |
| (503) 741-3636 | |
| Not Available |
| Full Name | Earth Source Medicine |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1490 Commercial St Ste 200, Astoria, Oregon |
| Authorized Official Name and Position | Carolyn Iacullo Nygaard (OWNER) |
| Authorized Official Contact | 5037413636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Earth Source Medicine 1490 Commercial St Ste 200 Astoria OR 97103-3800 Ph: (503) 741-3636 | Earth Source Medicine 1490 Commercial St Ste 200 Astoria OR 97103-3800 Ph: (503) 741-3636 |
| NPI Number | 1164952495 |
|---|---|
| Provider Enumeration Date | 06/19/2017 |
| Last Update Date | 07/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164952495 | NPI | - | NPPES |
| 500642404 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Oregon) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Bobek Enterprises Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 15th St, Astoria, OR 97103 Phone: 503-325-5411 Fax: 503-325-3711 | |
Columbia Lutheran Charities Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2158 Exchange St Ste 107, Astoria, OR 97103 Phone: 503-338-4675 Fax: 503-338-4676 | |
Thomas S. Duncan Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 595 18th St, Astoria, OR 97103 Phone: 503-325-9131 Fax: 888-371-4110 | |
Columbia Lutheran Charities Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2158 Exchange St Ste 107, Astoria, OR 97103 Phone: 503-338-4675 Fax: 503-338-4676 | |
North Coast Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 818 Commercial St Ste 103, Astoria, OR 97103 Phone: 503-568-7497 | |
Clatsop County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 Exchange St, Suite 100, Astoria, OR 97103 Phone: 503-338-3600 Fax: 503-325-8678 | |
Pacific Family Medicine Llp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2055 Exchange St, Ste 190, Astoria, OR 97103 Phone: 503-325-5300 Fax: 503-325-5400 |