Provider Demographics
NPI:1194824219
Name:TERAGLI, CHRISTINE ALICE (CRN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ALICE
Last Name:TERAGLI
Suffix:
Gender:F
Credentials:CRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15917 NW LOGIE TRAIL
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-8152
Mailing Address - Country:US
Mailing Address - Phone:503-647-2318
Mailing Address - Fax:503-647-2318
Practice Address - Street 1:15917 NW LOGIE TRAIL
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-8152
Practice Address - Country:US
Practice Address - Phone:503-647-2318
Practice Address - Fax:503-647-2318
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
098222OtherOMAP