Individual
COREY MOELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2824 NE MODA WAY APT 1335, HILLSBORO, OR 97124-7234
(503) 960-8828
Mailing address
12450 SW WALKER RD, BEAVERTON, OR 97005-1401
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
02/14/2020
Last updated
02/14/2020
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