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1194789453
LARRY L MOFFETT
CLACKAMAS, OR
NPI
1194789453
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: OR DO15179)
Enumeration Date
2006-04-13
Last Update Date
2010-03-17
Business Address
-- LARRY L MOFFETT DO
11211 SE SUNNYSIDE RD
CLACKAMAS, OR 97015-7787
Phone number: 503-659-0880
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Mailing Address
-- LARRY L MOFFETT DO
PO BOX 92900
PORTLAND, OR 97292-0900
Phone number: 503-659-0880
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