Individual
PAULA S MOOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
9205 SW BARNES RD, 7W, PORTLAND, OR 97225-6603
(503) 216-2028
Mailing address
PO BOX 4949, PORTLAND, OR 97208-4949
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
200350042NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273934
—
OR
01
—
P00461868
RR MEDICARE
OR
Enumeration date
07/04/2006
Last updated
06/19/2008
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