OrganizationActive
Wild Earth Wellness
NPI 1285159251 · Health Service Clinic/Center · Gresham, OR
Wild Earth Wellness is a Health Service Clinic/Center organization in Gresham, OR (NPI 1285159251).
Provider details
- NPI number
- 1285159251
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jennifer Boom, Owner(503) 310-2622
- License
- 7615 (OR)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
24850 Se Stark St Ste 200
Gresham, OR 97030-8320
Phone: (503) 310-2622
Street-level locationGet directions
Mailing address
24850 Se Stark St Ste 200
Gresham, OR 97030-8320
Registry dates
- Enumerated
- 2017-08-10
- Last updated
- 2022-07-21
Frequently asked questions
- What is Wild Earth Wellness's NPI number?
- Wild Earth Wellness's National Provider Identifier (NPI) is 1285159251, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wild Earth Wellness?
- Wild Earth Wellness is classified in the NPPES registry as Health Service Clinic/Center (Ambulatory Health Care Facilities).
- Where is Wild Earth Wellness located?
- Wild Earth Wellness's practice location on file with NPPES is 24850 Se Stark St Ste 200, Gresham, OR 97030-8320.
- What is Wild Earth Wellness's phone number?
- The practice phone number listed in the NPPES registry for Wild Earth Wellness is (503) 310-2622.
- Who is the authorized official for Wild Earth Wellness?
- The authorized official listed on Wild Earth Wellness's NPPES record is Jennifer Boom, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wild Earth Wellness's NPI active?
- Yes — Wild Earth Wellness's NPI (1285159251) is active in the NPPES registry as of the last update on 2022-07-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.