Organization
COUNTY OF TILLAMOOK
Active
Parent organization
COUNTY OF TILLAMOOK
Other names
Tillamook County Health Department - Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF TILLAMOOK
Authorized official
MARLENE L PUTMAN JD (ADMINISTRATOR)
(503) 842-3922
Entity
Organization
Contact information
Practice address
805 IVY AVE STE B, TILLAMOOK, OR 97141-3758
(503) 842-3900
Mailing address
PO BOX 489, TILLAMOOK, OR 97141-0489
(503) 842-3900
(503) 842-3903
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128756
—
OR
Enumeration date
08/12/2020
Last updated
09/22/2020
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