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NPI Code Detail

MEDICARE: TESSA TORRES COTA

MEDICARE: TESSA TORRES COTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant984992OR

General Provider Information

NPI Number : 1629213699
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESSA TORRES COTA
Provider Business Mailing Address
First Line : 32 W HIGHLAND AVE
Second Line :
City : GRANITE FALLS
State : NC
Zip : 28630-1739
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6010 SW SHATTUCK RD
Second Line :
City : PORTLAND
State : OR
Zip : 97221-1043
Country : US
Telephone Number : 503-246-8811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2008
Last Update Date : 12/04/2008

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Directions to “ TESSA TORRES COTA” Practice Location

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