EARTH SOURCE MEDICINE
NPI 1164952495
Clinic/Center in Astoria, OR
NPI Status: Active since June 19, 2017
Contact Information
757 W MARINE DR STE 103
ASTORIA, OR
ZIP 97103
Phone: (207) 209-4858
Fax: (207) 405-2199
- Organization
- Clinic/Center
- Accepts Insurance
About EARTH SOURCE MEDICINE
This page provides the complete NPI Profile along with additional information for Earth Source Medicine, a provider established in Astoria, Oregon operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1164952495 assigned on June 2017. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated April 2026. The provider's
- NPI
- 1164952495
- Provider Legal Name
- EARTH SOURCE MEDICINE
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 757 W MARINE DR STE 103 ASTORIA, OR 97103
- Location Phone
- (207) 209-4858
- Location Fax
- (207) 405-2199
- Mailing Address
- 757 W MARINE DR STE 103 ASTORIA, OR 97103
- Mailing Phone
- (207) 209-4858
- Mailing Fax
- (207) 405-2199
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-19-2017
- Last Update Date
- 04-21-2026
- Code Navigator
Location Map
Secondary Locations
- 254 Commercial St Ste 258
Portland, ME 04101
(207) 209-4858
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License State
- OR
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 500642404 | MEDICAID (05) | OR |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1164952495, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164952495, enumerated as an "organization" on June 19, 2017.
The provider is located at 757 W MARINE DR STE 103 ASTORIA, OR 97103 and the phone number is (207) 209-4858.
Clinic/Center with taxonomy code 261Q00000X.
The provider might be accepting Accepts: Moda Health Plan, Inc., Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
