Provider Demographics
NPI:1730483256
Name:BUONFORTE, JUDITH CLAIRE (MOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:CLAIRE
Last Name:BUONFORTE
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 NW FLANDERS ST
Mailing Address - Street 2:409
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1154
Mailing Address - Country:US
Mailing Address - Phone:201-563-7053
Mailing Address - Fax:
Practice Address - Street 1:10600 SE MCLOUGHLIN BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7428
Practice Address - Country:US
Practice Address - Phone:503-496-0385
Practice Address - Fax:866-631-9368
Is Sole Proprietor?:No
Enumeration Date:2010-12-23
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist