COLUMBIA LUTHERAN CHARITIES — NPI 1225694706 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in SEASIDE, OR)

CMS-1500 Box 24J / 33a • NPI

1225694706

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QR1300X (CMS B4[14])

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

1111 N ROOSEVELT DR STE 210, SEASIDE, OR, 97138-4604

✓ 9-Digit EDI 837 ZIP+4 (97138-4604)

Practice Phone & Referral Fax

(503) 738-3002

Fax: (503) 738-3005

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1225694706 (COLUMBIA LUTHERAN CHARITIES) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1225694706` (NPI-2 Organization / Facility)
Provider / Legal Name	COLUMBIA LUTHERAN CHARITIES
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QR1300X` (Clinic/Center, Rural Health)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	1111 N ROOSEVELT DR STE 210, SEASIDE, OR, 97138-4604
Practice Telephone / Fax	Tel: (503) 738-3002 \| Fax: (503) 738-3005
Administrative Mailing Address	2111 EXCHANGE ST, ASTORIA, OR, 97103-3329
Enumeration & Last Sync	Enumerated: 2019-05-10 \| CMS Record Updated: 2019-11-21
Authorized Official	KIMBERLY THOMAS (Revenue Cycle Director)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1111 N ROOSEVELT DR STE 210, SEASIDE, OR, 97138-4604

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Plain-English Taxonomy & CMS Crosswalk (261QR1300X)

What Does Taxonomy Code 261QR1300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QR1300X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code B4[14] (Rural Health Clinic)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (COLUMBIA LUTHERAN CHARITIES)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QR1300X` — Clinic/Center, Rural Health Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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COLUMBIA LUTHERAN CHARITIES (NPI #1225694706)