TIGARD TENDERCARE PC
Ambulatory Health at Pacific Hwy, Portland, OR

License number
Oregon D9419
Category
Ambulatory Health
Type
Health Service
Owner
Name: JUSTIN RAY MAROSTICA D.M.D.
Title: PRESIDENT
Phone: (503) 670-7088
Address
Address
11960 SW Pacific Hwy, Portland, OR 97223
National Provider ID: 1023434271
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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TIGARD TENDERCARE

Portland, OR

Doing business as:
TIGARD TENDERCARE PC
Registration:
Mar 7, 2002
Addresses:
11565 SW Hall Blvd, Portland, OR 97223 (Physical)
11960 SW Pacific Hwy, Portland, OR 97223 (Mailing)
State ID:
6858195
Business type:
ASSUMED BUSINESS NAME
Agent:
Justin Marostica,11234 NW Kenzer Ct, Portland, OR 97229 (Physical)

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