Provider Demographics
NPI:1013305572
Name:TOLFO, CHRISTINE-ELISE LIGAN
Entity Type:Individual
Prefix:
First Name:CHRISTINE-ELISE
Middle Name:LIGAN
Last Name:TOLFO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 SE DIVISION ST APT 205
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1488
Mailing Address - Country:US
Mailing Address - Phone:916-346-8555
Mailing Address - Fax:
Practice Address - Street 1:9400 SW BEAVERTON HILLSDALE HWY STE 210
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3300
Practice Address - Country:US
Practice Address - Phone:916-346-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLP2707225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist