Provider Demographics
NPI:1164540993
Name:TOFFOLO, JAMES J (ND, PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:TOFFOLO
Suffix:
Gender:M
Credentials:ND, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 PINE MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9531
Mailing Address - Country:US
Mailing Address - Phone:503-888-8144
Mailing Address - Fax:
Practice Address - Street 1:1655 SW HIGHLAND AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2558
Practice Address - Country:US
Practice Address - Phone:541-699-8185
Practice Address - Fax:541-316-1799
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1115R175F00000X
OR3406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR891674017OtherREGENCE BLUE CROSS
ORR158127Medicare PIN