Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SAMUEL MOODY, PA-C
ActiveSAMUEL MOODY, PA-C is a Medical Physician Assistant healthcare provider located in PORTLAND, Oregon. NPI 1710655584 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · PORTLAND, OR
Registration Details
- NPI Number
- 1710655584
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 5, 2021 (4.9489763339509 yrs)
- Last Updated
- Jan 9, 2024
- License
-
PA217671 (OR)
Practice Information
- Address
-
3181 SW SAM JACKSON PARK RDPORTLAND, OR, 972393011Browse OR providers · Browse ZIP 97239
- Phone
- 5034946596
- Fax
- 5034944285
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| IZABELA MACIOLEK | PA-C | 1699771238 |
| PATRICK M BIRBECK | PAC | 1851397400 |
| NICOLE E. PARKER | PA-C | 1669478210 |
| LORI H KELLY | PA-C | 1689670226 |
| ROBERT TODD DIXON | P.A. | 1982602421 |
| ALYSSA RACHAEL PACE | PA-C | 1275527483 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.