Individual
MS. VICTORIA GRACE MOSSE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA, ATC,PTA
Contact information
Practice address
1620 SE ANKENY ST, PORTLAND, OR 97214-1448
(503) 546-0620
(503) 546-0620
Mailing address
7108 N IVANHOE ST, PORTLAND, OR 97203-3943
(503) 289-6361
(503) 546-0620
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT 503236
OR
Other
Enumeration date
11/10/2005
Last updated
07/08/2007
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