Tina Caputo

NPI #1811648579 in Gresham, Oregon

Provider Information

NPI Number: 1811648579
Entity Type: Organization
Organization Name: Tina Caputo
Subpart: Yes (part of a larger organization)
Parent Organization: TINA CAPUTO LMT
Primary Specialty: Clinic/Center
Enumeration Date: Jan 14, 2022
Last Updated: Jan 14, 2022

Practice Location

Address: 22400 SE STARK ST
City: Gresham
State: Oregon
ZIP Code: 97030-2656
Phone: (858) 204-9661

Authorized Official

Name: CHRISTINA MARIE GADZALA CAPTUO, L. AC.
Title: OWNER
Phone: (858) 204-9661

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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