Individual
DR. WYATT J 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 97239-3098
(503) 494-8211
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-8211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
39575
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OR
Other
Enumeration date
05/11/2020
Last updated
03/22/2026
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