Individual
DR. THEODORE ANTHONY TOLLIVORO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9900 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9777
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(800) 813-2000
(855) 524-5255
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
A132935
CA
207RG0100X
Gastroenterology Physician
Primary
MD224469
OR
Other
Enumeration date
04/04/2013
Last updated
08/05/2025
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