MRS. SALLY MARIE MOEGGENBERG (NPI# 1689982126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689982126 |
| Entity Type | Individual |
| Full Name | MRS. SALLY MARIE MOEGGENBERG |
| Credential | MPT |
| Practice Address |
3101 Sw Sam Jackson Park Rd Portland OR 97239-3009 |
| Mailing Address |
4063 Se Ash St Portland OR 97214-2017 |
| Practice Telephone | 5032213429 |
| Mailing Telephone | 5032343503 |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2010-09-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
2422 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3101 SW SAM JACKSON PARK RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-3009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710968375 | Brookley Valentine Holter | Physician Assistant | 3101 Sw Sam Jackson Park Rd, Shriner's Hospital for Children, Portland, OR 97239 | 2005-11-10 |
| 1932743127 | Sarah Virginia Lowe | Dietitian, Registered | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3095 | 2019-10-31 |
| 1548802960 | Richard Hannan | Student in an Organized Health Care Education/Training Program | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2019-10-17 |
| 1558902262 | Janan Chandrananth | Student in an Organized Health Care Education/Training Program | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2019-10-03 |
| 1245893007 | Elizabeth Ann Mandel | Nurse Practitioner | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3095 | 2019-04-17 |
| 1104396589 | Rebecca-kelly Grant Clark | Occupational Therapist | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3095 | 2018-11-28 |
| 1336629294 | Joel Hamilton Cowley | Physical Therapist | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2018-08-20 |
| 1104314350 | Shriners Hospitals for Children | Anesthesiology | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2018-04-24 |
| 1356863765 | Stephen Arran Butler | Student in an Organized Health Care Education/Training Program | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2017-07-07 |
| 1023547015 | Lucas Enen Annabell | Student in an Organized Health Care Education/Training Program | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2017-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275156101 | Pace Pediatric Therapy, Inc. | Physical Therapist | 3701 Se Milwaukie Ave Ste G, Portland, OR 97202-3835 | 2020-05-27 |
| 1164598462 | Joy Danielle Shank | Physical Therapist | 7203 Se Raymond St, Portland, OR 97206-4323 | 2006-11-28 |
| 1861453979 | Therapy Solutions for Kids, LLC | Physical Therapist | 5200 Sw Macadam Ave, Portland, OR 97239-6103 | 2006-03-29 |
| 1366998254 | Cressa Elizabeth Schuster | Physical Therapist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-08-30 |
| 1851845440 | Stephanie Williams | Physical Therapist | 9155 Sw Barnes Rd, Gerry Frank Center for Children, Portland, OR 97225-6625 | 2016-08-11 |
| 1184178725 | Kathryn Knudsen | Physical Therapist | 9155 Sw Barnes Rd, Portland, OR 97225-6625 | 2016-08-11 |
| 1063966794 | Jennifer J Rosoff | Physical Therapist | 9155 Sw Barnes Rd, Portland, OR 97225-6625 | 2016-08-10 |
| 1053682419 | Vicki Belinda Vadas | Physical Therapist | 196 Allen Ave, Portland, ME 04103-3711 | 2012-01-17 |
| 1184932659 | Kay Throckmorton | Physical Therapist | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2010-09-18 |
| 1477886232 | Childrens Intensive Therapy Northwest | Physical Therapist | 7203 Se Raymond St, Portland, OR 97206-4323 | 2009-09-11 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on MRS. SALLY MARIE MOEGGENBERG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.