Individual
MRS. LORINE STACI FORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
5289 NE ELAM YOUNG PKWY STE 140, HILLSBORO, OR 97124-7551
(503) 747-5359
(503) 266-8632
Mailing address
610 HIGH ST, OREGON CITY, OR 97045-2241
(503) 657-8903
(503) 266-8632
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1008573
OR
225X00000X
Occupational Therapist
46TR00110900
NJ
225X00000X
Occupational Therapist
OC009978
PA
Other
Enumeration date
03/19/2007
Last updated
04/27/2026
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