Healthcare Provider Details

I. General information

NPI: 1992798334
Provider Name (Legal Business Name): GILBERT PAUL MOYER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PAUL MOYER PA

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 PACIFIC AVE
HOOD RIVER OR
97031-1956
US

IV. Provider business mailing address

849 PACIFIC AVE
HOOD RIVER OR
97031-1956
US

V. Phone/Fax

Practice location:
  • Phone: 541-386-6380
  • Fax: 541-386-1078
Mailing address:
  • Phone: 541-386-6380
  • Fax: 541-386-1078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA00737
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: