MEDICARE: COLUMBIA LUTHERAN CHARITIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023038858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBIA LUTHERAN CHARITIES

Provider Business Mailing Address
First Line	:	2111 EXCHANGE ST
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-3329
Country	:	US
Telephone Number	:	503-325-4321
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 EXCHANGE ST STE 203
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-3364
Country	:	US
Telephone Number	:	503-338-6230
Fax Number	:	503-338-6240

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. ERIK THORSEN
Credential	:
Telephone Number	:	503-325-4321

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	06/03/2024

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Directions to “COLUMBIA LUTHERAN CHARITIES ” Practice Location

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