Provider Demographics
NPI:1861149502
Name:TIMBER DENTAL SHERWOOD LLC
Entity type:Organization
Organization Name:TIMBER DENTAL SHERWOOD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS LEAD
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-765-7355
Mailing Address - Street 1:3500 NE MLK BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2093
Mailing Address - Country:US
Mailing Address - Phone:503-765-7355
Mailing Address - Fax:
Practice Address - Street 1:21332 SW LANGER FARMS PKWY STE 126
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9138
Practice Address - Country:US
Practice Address - Phone:503-765-7355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental