Individual
RICHARD LEE TILLMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
833 SW 11TH AVE, SUITE 600, PORTLAND, OR 97205-2125
(503) 223-9725
Mailing address
6500 SE SCOTT DR, PORTLAND, OR 97215-2018
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4466
OR
Other
Enumeration date
07/26/2005
Last updated
07/08/2007
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