Provider Demographics
NPI:1992585079
Name:TESTA, VIRGINIA
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:
Last Name:TESTA
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 1:11610 NW STONE MOUNTAIN LN APT 302
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-5995
Mailing Address - Country:US
Mailing Address - Phone:503-915-2111
Mailing Address - Fax:
Practice Address - Street 1:11610 NW STONE MOUNTAIN LN APT 302
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-5995
Practice Address - Country:US
Practice Address - Phone:503-915-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula