Organization
TILLAMOOK SPECIALIST ASSOCIATES, LLC
Active
Parent organization
TILLAMOOK MEDICAL ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
TILLAMOOK MEDICAL ASSOCIATES
Authorized official
MR. SID RITTENBACH (ADMINISTRATOR)
(503) 842-5546
Entity
Organization
Contact information
Practice address
980 3RD ST, SUITE 500, TILLAMOOK, OR 97141-9469
(503) 842-5546
(503) 842-1444
Mailing address
980 3RD ST, SUITE 500, TILLAMOOK, OR 97141-9469
(503) 842-5546
(503) 842-1444
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213035
—
OR
Enumeration date
04/04/2007
Last updated
12/20/2007
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