Individual
ROMA MOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225
(503) 216-2906
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10042714
TX
207R00000X
Internal Medicine Physician
Primary
MD189242
OR
208000000X
Pediatrics Physician
BP10042714
TX
208000000X
Pediatrics Physician
MD189242
OR
208000000X
Pediatrics Physician
Q8577
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500754746
—
OR
Enumeration date
04/20/2012
Last updated
10/05/2020
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