1. Home
  2. Directory
  3. Oregon
  4. Gresham
  5. Clinic Center
  6. NPI Profile

WILD EARTH WELLNESS
NPI 1285159251
Clinic/Center - Health Service in Gresham, OR

Active since August 10, 2017
24850 SE STARK ST STE 200, GRESHAM, OR 97030(503) 310-2622 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Aug 10, 2017 (2 updates tracked since 2017).

About Wild Earth Wellness NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILD EARTH WELLNESS (NPI 1285159251) is a healthcare organization registered as a health service in Gresham, Oregon and active in the NPI registry since August 2017. The organization lists Jennifer Marie Boom, Owner, as its authorized official.

NPPES Registry Identity

NPI1285159251
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameWILD EARTH WELLNESS
Location Address24850 SE STARK ST STE 200Gresham, OR 97030-8320
Mailing Address24850 Se Stark St Ste 200Gresham, OR 97030-8320 · (503) 310-2622
Phone(503) 310-2622
Organization SubpartNo
Authorized OfficialJennifer Marie BoomOwner · (503) 310-2622
Enumeration DateAugust 10, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1285159251 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
License✔ Licensed in OR · 7615
24850 SE STARK ST STE 200, Gresham, OR 97030
Open in Google Maps ↗

Other Identifiers 1

Other1164547634Npi

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LORITA ELAINE JOHNSON LMT
Mechanotherapist
24850 SE STARK ST STE 200
GRESHAM, OR 97030
Multnomah County (971) 285-2905
AUDRA RACHELLE NORRIS-JACOB MD
Obstetrics & Gynecology
24850 SE STARK ST STE 200
GRESHAM, OR 97030
Multnomah County (503) 491-9444
MS. KIRSTEN GWYNN CNM
Advanced Practice Midwife
24850 SE STARK ST STE 200
GRESHAM, OR 97030
Multnomah County (503) 491-9444
BRITTA AMEEL
Obstetrics & Gynecology
24850 SE STARK ST STE 200
GRESHAM, OR 97030
Multnomah County (503) 491-9444
JULIE SHIPRACK CNM
Advanced Practice Midwife
24850 SE STARK ST STE 200
GRESHAM, OR 97030
Multnomah County (503) 491-9444
FAITH SAMAAN
Lactation Consultant, Non-RN
24850 SE STARK ST STE 200
GRESHAM, OR 97030
Multnomah County (503) 317-5036
MS. MONICA ELIZABETH VENN D.O.
Obstetrics & Gynecology
24850 SE STARK ST STE 200
GRESHAM, OR 97030
Multnomah County (503) 491-9444
SHANNON THURSTON CNM
Advanced Practice Midwife
24850 SE STARK ST STE 200
GRESHAM, OR 97030
Multnomah County (503) 491-9444

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wild Earth Wellness's NPI number?

The NPI number for Wild Earth Wellness is 1285159251. It was assigned to this organization in the NPPES registry on August 10, 2017.

Where is Wild Earth Wellness located?

Wild Earth Wellness is located at 24850 SE Stark St Ste 200, Gresham, OR 97030. The listed phone number is (503) 310-2622.

What is Wild Earth Wellness's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Wild Earth Wellness was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.