Organization
TILLAMOOK MEDICAL ASSOCIATES LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SID RITTENBACH (ADMINISTRATOR)
(503) 842-5546
Entity
Organization
Contact information
Practice address
980 3RD ST, SUITE 200, TILLAMOOK, OR 97141-9469
(503) 842-5546
(503) 842-1444
Mailing address
980 3RD ST, SUITE 200, TILLAMOOK, OR 97141-9469
(503) 842-5546
(503) 842-1444
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019547
—
OR
Enumeration date
11/11/2005
Last updated
08/22/2020
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