| Tina Caputo | |
|
22400 Se Stark St Gresham OR 97030-2656 | |
| (858) 204-9661 | |
| Not Available |
| Full Name | Tina Caputo |
|---|---|
| Speciality | Clinic/center |
| Location | 22400 Se Stark St, Gresham, Oregon |
| Authorized Official Name and Position | Christina Marie Gadzala Captuo (OWNER) |
| Authorized Official Contact | 8582049661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tina Caputo 22400 Se Stark St Gresham OR 97030-2656 Ph: () - | Tina Caputo 22400 Se Stark St Gresham OR 97030-2656 Ph: (858) 204-9661 |
| NPI Number | 1811648579 |
|---|---|
| Provider Enumeration Date | 01/14/2022 |
| Last Update Date | 01/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811648579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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