Individual
LISA A MOELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1835 PEARL ST, EUGENE, OR 97401-8217
(541) 687-1668
(541) 684-3061
Mailing address
PO BOX 1648, EUGENE, OR 97440-1648
(541) 687-1668
(541) 684-3061
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00444
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500610815
—
OR
Enumeration date
01/19/2006
Last updated
10/26/2011
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