Individual
SELENA MOFFITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5331 SW MACADAM AVE STE 380, PORTLAND, OR 97239-3879
(503) 894-9118
Mailing address
12850 SE 257TH AVE, DAMASCUS, OR 97089
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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