Individual
JESUS ARMANDO MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 DIVISION ST, OREGON CITY, OR 97045-1527
(503) 650-6270
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL18729
OR
207R00000X
Internal Medicine Physician
MD158617
OR
208M00000X
Hospitalist Physician
Primary
MD158617
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500647853
—
OR
01
—
P01115326
RR MEDICARE (PH&S)-PMG
OR
Enumeration date
06/09/2009
Last updated
11/15/2021
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