Individual
SARA MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-5945
Mailing address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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