Provider Demographics
NPI:1083141618
Name:MOSHOFSKY, DANIEL (PSYD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MOSHOFSKY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18840 SW BOONES FERRY RD STE 208
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9688
Mailing Address - Country:US
Mailing Address - Phone:503-427-2394
Mailing Address - Fax:
Practice Address - Street 1:18840 SW BOONES FERRY RD STE 208
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9688
Practice Address - Country:US
Practice Address - Phone:503-427-2394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-14
Last Update Date:2017-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health