| Jeff Moody, Llc | |
|
307 E 2nd St Ste 250 Newberg OR 97132-3077 | |
| (405) 620-3508 | |
| Not Available |
| Full Name | Jeff Moody, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 307 E 2nd St Ste 250, Newberg, Oregon |
| Authorized Official Name and Position | Jeffrey Moody (MANAGER) |
| Authorized Official Contact | 4056203508 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeff Moody, Llc 307 E 2nd St Ste 250 Newberg OR 97132-3077 Ph: () - | Jeff Moody, Llc 307 E 2nd St Ste 250 Newberg OR 97132-3077 Ph: (405) 620-3508 |
| NPI Number | 1912566951 |
|---|---|
| Provider Enumeration Date | 06/12/2019 |
| Last Update Date | 06/12/2019 |
| Medicare PECOS PAC ID | 5092043208 |
|---|---|
| Medicare Enrollment ID | O20190827000891 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912566951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jeffrey A Moody |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093882599 PECOS PAC ID: 0345578555 Enrollment ID: I20190827001062 |
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