Provider Demographics
NPI:1376083121
Name:CAULFIELD, CAROLINE JEAN
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:JEAN
Last Name:CAULFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CAROLINE
Other - Middle Name:JEAN
Other - Last Name:WAMPFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:25117 SW PARKWAY AVE
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9697
Mailing Address - Country:US
Mailing Address - Phone:503-570-3665
Mailing Address - Fax:
Practice Address - Street 1:14232 SE MILL CT
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-2370
Practice Address - Country:US
Practice Address - Phone:503-960-2043
Practice Address - Fax:503-261-8468
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3930405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional