Provider Demographics
NPI:1952437238
Name:MOSES, DIANA LYNNE (RN, CNS)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:LYNNE
Last Name:MOSES
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:LYNNE
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CNS, MS, CNRN
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:503-215-6494
Mailing Address - Fax:503-215-6644
Practice Address - Street 1:9155 SW BARNES RD
Practice Address - Street 2:STE 317
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6625
Practice Address - Country:US
Practice Address - Phone:503-216-1150
Practice Address - Fax:503-216-1095
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200040226RN163WN0800X
OR2000670014CNS364SN0800X
OR200670014CNS364S00000X, 364SN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
No364SN0800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeuroscience