Organization
COUNTY OF TILLAMOOK
Active
Other names
Tillamook County Health Department - Mobile Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARLENE L PUTMAN (ADMINISTRATOR)
(503) 842-3922
Entity
Organization
Contact information
Practice address
1925 SUPPRESS RD N, TILLAMOOK, OR 97141-9296
(503) 842-3900
(503) 842-3903
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
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128756
—
OR
Enumeration date
08/01/2019
Last updated
09/23/2019
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