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General NPI Number Information
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NPI Number | 1154298677
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Entity Type | Organization
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Legal Business Name | ELEMENTAL PEDIATRICS, LLC
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 1113 JUNE ST
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City | HOOD RIVER
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State | OR
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Zip | 97031-1512
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Country | US
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Telephone | 541-224-7951
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Fax | 541-224-7952
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Provider Business Mailing Address
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Address Line | 1767 12TH ST # 171
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City | HOOD RIVER
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State | OR
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Zip | 97031-9531
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Country | US
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Telephone | 541-224-7951
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Fax | 541-224-7952
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Authorized Official
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Title or Position | EXECUTIVE CLINICAL DIRECTOR
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Name | DR. LYNNE ANNE FROST BARON
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Credential | DNP, APRN
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Telephone | 541-224-7951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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