Individual provider · NPI-1
Dr. Walaa F. R. Abdelmoaty, MD
Preventive Medicine, Occupational Medicine · Tigard, OR
NPI number1033686704
StatusActive
Last updated in NPPESSep 30, 2024
Details
- NPI
- 1033686704
- Entity type
- Individual (NPI-1)
- Name
- Dr. Walaa F. R. Abdelmoaty
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 30, 2018
- Certification date
- Sep 30, 2024
- Last updated
- Sep 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2083X0100X | Preventive Medicine, Occupational Medicine | MD219357 | OR | Yes |
| 2083P0500X | Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine | 12701017-1205 | UT | |
| 208D00000X | General Practice | MD61191640 | WA |
Practice location
18040 Sw Lower Boones Ferry Rd Ste 100Tigard, OR 97224-7259
Phone 503-216-0624
Mailing address
Po Box 3158Portland, OR 97208-3158
Phone 503-215-6494
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