Organization
COLUMBIA BASIN BATH RENOVATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT ALAN MOORE CONTRACTOR (OWNER)
(541) 701-5341
Entity
Organization
Contact information
Practice address
736 RANDALL ST, UMATILLA, OR 97882-9501
(541) 701-5341
Mailing address
736 RANDALL ST, UMATILLA, OR 97882-9501
(541) 701-5341
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
195517
OR
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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