Provider Demographics
NPI:1306534003
Name:TORRES-JOLI, TRISTA LYNN
Entity type:Individual
Prefix:
First Name:TRISTA
Middle Name:LYNN
Last Name:TORRES-JOLI
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 1:145 S HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:OR
Mailing Address - Zip Code:97146-9314
Mailing Address - Country:US
Mailing Address - Phone:503-861-1611
Mailing Address - Fax:503-861-3322
Practice Address - Street 1:145 S HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146-9314
Practice Address - Country:US
Practice Address - Phone:503-861-1611
Practice Address - Fax:503-861-3322
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCPT-0012720183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician