Provider Demographics
NPI:1538495965
Name:FORTES LABORATORIES INC
Entity Type:Organization
Organization Name:FORTES LABORATORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCKOWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-682-9106
Mailing Address - Street 1:25749 SW CANYON CREEK RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-6629
Mailing Address - Country:US
Mailing Address - Phone:877-458-6710
Mailing Address - Fax:503-682-8668
Practice Address - Street 1:25749 SW CANYON CREEK RD
Practice Address - Street 2:SUITE 600
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070
Practice Address - Country:US
Practice Address - Phone:877-458-6710
Practice Address - Fax:503-682-8668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR552032-94291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory