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NPI Code Detail

MEDICARE: ALEXANDRA TAYLOR MOSKOW LMT

MEDICARE: ALEXANDRA TAYLOR MOSKOW LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist27480OR

General Provider Information

NPI Number : 1144927310
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA TAYLOR MOSKOW LMT
Provider Business Mailing Address
First Line : 2131 SE HAWTHORNE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97214-3852
Country : US
Telephone Number : 925-640-1588
Fax Number :
Provider Business Practice Location Address
First Line : 4230 NE FREMONT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97213-1150
Country : US
Telephone Number : 503-208-5532
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2023
Last Update Date : 02/08/2023

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Directions to “ ALEXANDRA TAYLOR MOSKOW LMT” Practice Location

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