Provider Demographics
NPI:1659328755
Name:COLUMBIA HEALTH SERVICES
Entity Type:Organization
Organization Name:COLUMBIA HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:LAROSE
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:503-397-4651
Mailing Address - Street 1:PO BOX 995
Mailing Address - Street 2:2370 GABLE RD
Mailing Address - City:ST HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051-0995
Mailing Address - Country:US
Mailing Address - Phone:503-397-4651
Mailing Address - Fax:503-397-1424
Practice Address - Street 1:2370 GABLE RD
Practice Address - Street 2:
Practice Address - City:ST HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-2913
Practice Address - Country:US
Practice Address - Phone:503-397-4651
Practice Address - Fax:503-397-1424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251B00000XAgenciesCase Management
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR042056Medicaid
OR042940Medicaid
OR320507Medicaid