Provider Demographics
NPI:1013032614
Name:MOVIUS, ROSALIE LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:LOUISE
Last Name:MOVIUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 SW OLESON RD
Mailing Address - Street 2:B 154
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-7475
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7410 SW OLESON RD
Practice Address - Street 2:B 154
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-7475
Practice Address - Country:US
Practice Address - Phone:503-309-7802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18330208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice