Individual
MOSES SUJAD IJAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3036 NE MLK JR BLVD, PORTLAND, OR 97212-3053
(503) 283-3763
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
34. 005207
OH
2084P0800X
Psychiatry Physician
Primary
DO195772
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2275621
—
OH
05
—
500776126
—
OR
Enumeration date
04/13/2006
Last updated
04/09/2025
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