Provider Demographics
NPI:1134353840
Name:ALTILIO, TIFFANY SCHUMACHER (DC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:SCHUMACHER
Last Name:ALTILIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 NE RAY CIR
Mailing Address - Street 2:STE. 140
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6429
Mailing Address - Country:US
Mailing Address - Phone:503-484-3638
Mailing Address - Fax:
Practice Address - Street 1:5920 NE RAY CIR
Practice Address - Street 2:STE. 140
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6429
Practice Address - Country:US
Practice Address - Phone:503-484-3638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-08
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor