| Tillamook County Health Department - Cloverdale Clinic | |
|
34325 Highway 101 S Cloverdale OR 97112-9400 | |
| (503) 842-3900 | |
| (503) 842-3903 |
| Full Name | Tillamook County Health Department - Cloverdale Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 34325 Highway 101 S, Cloverdale, Oregon |
| Authorized Official Name and Position | Marlene L Putman (ADMINISTRATOR) |
| Authorized Official Contact | 5038423900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tillamook County Health Department - Cloverdale Clinic Po Box 489 Tillamook OR 97141-0489 Ph: (503) 842-3900 | Tillamook County Health Department - Cloverdale Clinic 34325 Highway 101 S Cloverdale OR 97112-9400 Ph: (503) 842-3900 |
| NPI Number | 1730341975 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 07/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730341975 | NPI | - | NPPES |
| 116488 | Other | OR | NORIDIAN |
| 128756 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |