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General NPI Number Information
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NPI Number | 1396364717
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Entity Type | Individual
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Provider Name | NATALIA MOSAILOVA DO
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Gender | Female
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 05/25/2024
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Provider Practice Location Address
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Address Line | 400 NE MOTHER JOSEPH PL
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City | VANCOUVER
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State | WA
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Zip | 98664-3200
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Country | US
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Telephone | 360-514-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 3181 SW SAM JACKSON PARK RD
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City | PORTLAND
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State | OR
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Zip | 97239-3011
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Country | US
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Telephone | 503-803-0323
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OP61401129
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License Number State | WA
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