Individual
MARIA GROMPE MOREDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5856
(503) 494-2370
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5856
(503) 494-2370
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
PA190467
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/29/2016
Last updated
05/14/2025
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