Organization
TINA CAPUTO LMT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA CAPUTO LAC (LAC)
(858) 204-9661
Entity
Organization
Contact information
Practice address
22400 SE STARK ST, GRESHAM, OR 97030-2656
(858) 204-9661
Mailing address
22400 SE STARK ST, GRESHAM, OR 97030-2656
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/05/2019
Last updated
01/21/2022
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