Provider Demographics
NPI:1659952224
Name:MOESER, SARAH (LAC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MOESER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15515 SE RHONE CT
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-2246
Mailing Address - Country:US
Mailing Address - Phone:509-595-6667
Mailing Address - Fax:
Practice Address - Street 1:2690 MAY ST STE 101
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9786
Practice Address - Country:US
Practice Address - Phone:541-387-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC203780171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist