Individual
TERRY MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4651 NE KILLINGSWORTH ST UNIT 24, PORTLAND, OR 97218-1950
(520) 624-0927
Mailing address
4035 NE SANDY BLVD STE 200, PORTLAND, OR 97212-5331
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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