Healthcare Provider Details

I. General information

NPI: 1194824219
Provider Name (Legal Business Name): CHRISTINE ALICE TERAGLI CRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15917 NW LOGIE TRAIL
HILLSBORO OR
97124-8152
US

IV. Provider business mailing address

15917 NW LOGIE TRAIL
HILLSBORO OR
97124-8152
US

V. Phone/Fax

Practice location:
  • Phone: 503-647-2318
  • Fax: 503-647-2318
Mailing address:
  • Phone: 503-647-2318
  • Fax: 503-647-2318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: