Individual
DAVID K. MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-2906
(503) 216-4114
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD23264
OR
208M00000X
Hospitalist Physician
Primary
MD23264
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129981
—
OR
05
—
8233157
—
WA
01
—
P00465304
RR MEDICARE
OR
Enumeration date
06/23/2005
Last updated
07/26/2021
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