Individual
BENJAMIN MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-1620
(503) 494-6670
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-1620
(503) 494-6670
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD215320
OR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD215320
OR
207RP1001X
Pulmonary Disease Physician
Primary
MD215320
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2017
Last updated
10/16/2023
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