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Organization

ORTC, LLC

Active
Parent organization
ORTC, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
ORTC, LLC
Authorized official
DANA JORGENSEN (CREDENTIALING)
(541) 322-1794
Entity
Organization

Contact information

Practice address
2121 ISAACS AVE, WALLA WALLA, WA 99362-2215
(509) 578-1492
(509) 578-1493
Mailing address
2121 ISAACS AVE, WALLA WALLA, WA 99362-2215
(253) 263-7057
(541) 237-0988

Taxonomy

Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
BHA.FS.70024367
WA
Enumeration date
03/10/2026
Last updated
03/10/2026
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