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Justin Moss, DO
General Practice Physician in Lebanon, Oregon
NPI 1265991640

Justin Moss is a General Practice Physician based in Lebanon, OR. Justin Moss practices in Lebanon, OR and has the professional credentials of DO. The NPI Number for Justin Moss is 1265991640 and holds a License No. (Oregon).

The current practice location address for Justin Moss is 200 Mullins Dr, Lebanon, OR and can be reached out via phone at 253-651-5881.

Location: 200 Mullins Dr, Lebanon, OR, 97355-3983
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265991640
Provider Name
Justin Moss
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
200 Mullins Dr, Lebanon, OR, 97355-3983
Phone Number
253-651-5881
Fax Number
Provider Enumeration Date
03/15/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
200 Mullins Dr
City
Lebanon
State
Oregon
Zip
97355-3983
Phone Number
253-651-5881
Fax Number
person
Provider Business Mailing Address Details
Address
200 Mullins Dr
City
Lebanon
State
Oregon
Zip
97355-3983
Phone Number
253-651-5881
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
0102207468 (Virginia)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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