Provider Demographics
NPI:1710875877
Name:EAST WIND CARE LLC
Entity type:Organization
Organization Name:EAST WIND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:IVY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEABURG
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, DNP
Authorized Official - Phone:503-953-6836
Mailing Address - Street 1:PO BOX 161
Mailing Address - Street 2:
Mailing Address - City:CORBETT
Mailing Address - State:OR
Mailing Address - Zip Code:97019-0161
Mailing Address - Country:US
Mailing Address - Phone:503-953-6836
Mailing Address - Fax:
Practice Address - Street 1:30144 E WOODARD RD
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-9312
Practice Address - Country:US
Practice Address - Phone:503-953-6836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care