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Wild Earth Wellness

Health Service Clinic/Center in Gresham, OR · enumerated 2017 · authorized official Jennifer Boom, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1285159251

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Registry record

Entity type Organization (Type 2)
Legal business name Wild Earth Wellness
Practice address 24850 Se Stark St Ste 200, Gresham, OR, 97030
Phone (503) 310-2622
Enumeration date Aug 10, 2017
Last updated in NPPES Jul 21, 2022

Taxonomy & classification

261QH0100X Health Service Clinic/Center Ambulatory Health Care Facilities · License 7615 (OR) Primary

Authorized official

Name Jennifer Boom
Title Owner
Phone (503) 310-2622

Other identifiers

Identifier Type State Issuer
1164547634 Other - NPI

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2022-07-21. Verify at npiregistry.cms.hhs.gov.
Where is Wild Earth Wellness located?
The practice location on file with NPPES is in Gresham, OR.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-07-21.