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1639697709
HALEY BROOKE MOAK
PORTLAND, OR
NPI
1639697709
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2017-09-08
Last Update Date
2017-09-08
Business Address
HALEY BROOKE MOAK PA-C
10803 SE CHERRY BLOSSOM DR
PORTLAND, OR 97216-3107
Phone number: 503-261-7200
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Mailing Address
HALEY BROOKE MOAK PA-C
911 SW 21ST AVE APT 204
PORTLAND, OR 97205-1565
Phone number: 541-519-2923
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