Organization
MODA WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LOU TRUE (CHIEF HUMAN RESOURCE OFFICER)
(503) 702-3164
Entity
Organization
Contact information
Practice address
5331 S MACADAM AVE STE 260, PORTLAND, OR 97239-3863
(503) 243-3967
(503) 243-3895
Mailing address
5331 S MACADAM AVE STE 260, PORTLAND, OR 97239-3863
(503) 243-3967
(503) 243-3895
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
—
—
Other
Enumeration date
05/29/2025
Last updated
05/29/2025
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