Individual
IRMA MAGDALENA MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4010 AERIAL WAY, EUGENE, OR 97402-9757
(541) 242-8300
(541) 242-8355
Mailing address
2882 GREENTREE WAY, EUGENE, OR 97405-1225
(541) 905-1624
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
202113246NP-PP
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/02/2021
Last updated
10/18/2022
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