Provider Demographics
NPI:1376635748
Name:MOSHTAEL, NAGHMEH (MD)
Entity Type:Individual
Prefix:DR
First Name:NAGHMEH
Middle Name:
Last Name:MOSHTAEL
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 1:8709 SE MORRISON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-1724
Mailing Address - Country:US
Mailing Address - Phone:503-282-0783
Mailing Address - Fax:
Practice Address - Street 1:3530 N VANCOUVER AVE STE 400
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1798
Practice Address - Country:US
Practice Address - Phone:503-249-8851
Practice Address - Fax:503-282-3409
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25716208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics