Tina Caputo Lmt

NPI #1902440738 in Gresham, Oregon

Provider Information

NPI Number: 1902440738
Entity Type: Organization
Organization Name: Tina Caputo Lmt
Primary Specialty: Clinic/Center
Enumeration Date: Nov 5, 2019
Last Updated: Jan 21, 2022

Practice Location

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

Authorized Official

Name: TINA CAPUTO, LAC
Title: LAC
Phone: (858) 204-9661

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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