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Individual

LAURA C MOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-4818
Mailing address
1901 ESTHER ST, NEWBERG, OR 97132-9529
(503) 554-4325

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
MD 39129
WA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
MD150515
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8395154
WA
01
AB32999
MEDICARE GROUP
WA
Enumeration date
05/11/2006
Last updated
11/01/2015
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