| Organization Name: | COUNTY OF TILLAMOOK |
| NPI Number: | 1730341975 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARLENE L PUTMAN (ADMINISTRATOR) |
| Mailing Address: | 34335 Hwy 101 South Cloverdale |
| State: | OR US |
| Postal Code: | 97112 |
| Phone Number: | 5033924200 |
| Fax Number: | |
| NPI Enumeration Date: | 06/30/2008 |
| NPI Last Update Date: | 05/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | MD11776 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |