Healthcare Provider Details

I. General information

NPI: 1811821796
Provider Name (Legal Business Name): LUMINIFY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19365 SW 65TH AVE STE 205
TUALATIN OR
97062-9196
US

IV. Provider business mailing address

19365 SW 65TH AVE STE 205
TUALATIN OR
97062-9196
US

V. Phone/Fax

Practice location:
  • Phone: 971-825-2015
  • Fax:
Mailing address:
  • Phone: 971-825-2015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARITY CAPURAS
Title or Position: OWNER AND MEDICAL DIRECTOR
Credential: NP
Phone: 971-825-2015