Healthcare Provider Details

I. General information

NPI: 1689260358
Provider Name (Legal Business Name): ASTORIA BIRTH CENTER PROVIDERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 12/17/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 MARINE DR
ASTORIA OR
97103-3808
US

IV. Provider business mailing address

1406 MARINE DR
ASTORIA OR
97103-3808
US

V. Phone/Fax

Practice location:
  • Phone: 509-539-3985
  • Fax: 503-376-6716
Mailing address:
  • Phone: 509-539-3985
  • Fax: 503-376-6716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: REBECKAH MARIE ORTON
Title or Position: MANAGER
Credential:
Phone: 509-539-3985