Individual
BART CLIFTON MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-1620
(503) 494-6670
Mailing address
3181 SW SAM JACKSON PARK RD, UHN67, PORTLAND, OR 97239-3011
(503) 494-1620
(503) 494-6670
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
45853
CO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD150813
OR
207RP1001X
Pulmonary Disease Physician
Primary
MD150813
OR
Other
Enumeration date
01/26/2007
Last updated
02/19/2021
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