JORDAN EDWARD MOON


Address: 2280 Marcola Rd, Springfield, OR 97477-2594
Phone: 5417474300

JORDAN EDWARD MOON (NPI# 1770031221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770031221
Entity Type Individual
Full Name JORDAN EDWARD MOON
Credential PA-C, MPH
Practice Address 2280 Marcola Rd
Springfield
OR 97477-2594
Practice Telephone 5417474300
Practice Fax Number 5417470655
Mailing Telephone 5417474300
Mailing Fax Number 5417470655
Enumeration Date 2016-09-13
Last Update Date 2016-09-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA179905 OR Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2280 MARCOLA RD
City SPRINGFIELD
State OR
Zip Code 97477-2594

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154320380 Michael Stan Findley Family Medicine 2280 Marcola Rd, Springfield, OR 97477-2594 2005-07-19
1700483518 Peter Randall Hill Physician Assistant 2280 Marcola Rd, Springfield, OR 97477-2594 2020-10-05
1871106914 Viet Quoc Nguyen Pharmacist 2280 Marcola Rd, Springfield, OR 97477-2594 2020-08-28
1417567082 Willem Poelmans Physician Assistant 2280 Marcola Rd, Springfield, OR 97477-2594 2020-08-07
1528605086 Reed Casey Janke Family Medicine 2280 Marcola Rd, Springfield, OR 97477-2594 2019-12-04
1780230284 April Noelle Tharp Family Medicine 2280 Marcola Rd, Springfield, OR 97477-2594 2019-08-12
1205481801 Ashley Lynne Johns Physician Assistant 2280 Marcola Rd, Springfield, OR 97477-2594 2019-08-09
1376009282 Wendy Renee Hounsel Nurse Practitioner 2280 Marcola Rd, Springfield, OR 97477-2594 2019-02-15
1952890402 Jonathan David Duke Pharmacist 2280 Marcola Rd, Springfield, OR 97477-2594 2018-05-09
1003340613 Alejandro Elliott Colmenero I Physician Assistant 2280 Marcola Rd, Springfield, OR 97477-2594 2017-04-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1508416140 Chase Michael Collings Physician Assistant 960 N 16th St Ste 303, Springfield, OR 97477 2019-09-16
1174079396 Amie Flanagan Occupational Therapy Assistant 3152 Valentine Court, Springfield, OR 97477 2016-08-28
1609229590 Kiernan Davis Snedigar Counselor 175 W B St Ste J, Springfield, OR 97477 2016-07-15
1578914206 Ryan James Dixon Counselor 1923 Centennial Blvd, Springfield, OR 97477 2016-06-23
1902275464 Jovonnie Bashaw Counselor 1157 5th St, Springfield, OR 97477 2015-09-15
1053759506 Norco Inc Durable Medical Equipment & Medical Supplies 302 Shelley St Ste 7&8, Springfield, OR 97477 2013-06-06
1780931634 Justin Morris Pharmacist 1891 Pioneer Parkway East, Springfield, OR 97477 2012-08-09
1194083105 Mersedeh Bahr Hosseini Psychiatry & Neurology 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 2012-04-26
1962769679 Hiro Kawata Internal Medicine 3311 Rierbend Dr., Springfield, OR 97477 2012-04-19
1659662823 Wendy A Teigen Counselor 3995 Marcola Rd., Springfield, OR 97477 2011-04-22
Find all providers in zip 97477

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871122168 Alexandra Emmanuelle Rochman Physician Assistant 54 W Crystal Brook Dr, Springfield, MA 01118-1946 2020-04-07
1740740737 Western New England University Physician Assistant 215 Wilbraham Road, Springfield, MA 01119 2019-03-25
1033462387 Miguel Angel Medina Physician Assistant 1900 South Sunshine Ave., Springfield, MO 65807 2012-10-24
1770850216 Lauren Jennifer Navas Physician Assistant 100 River St Ste 2, Springfield, VT 05156-2930 2011-11-29
1295885168 Jacqueline Kernaghan Physician Assistant 723 Saxer Ave, Springfield, PA 19064-3503 2007-01-11
1295746733 Gwen Wright Physician Assistant 194 W Sproul Rd, Suite 105, Springfield, PA 19064-2027 2006-08-10
1164490710 Stacie L Pierce Physician Assistant 3721 W El Castile St, Springfield, MO 65807-5431 2006-03-09
1245206432 Annette K Bates Physician Assistant 819 Worcester St Ste 3, Springfield, MA 01151-1056 2006-02-27
1518947159 Louis Patrick Favata Physician Assistant 140 High St., Springfield, MA 01199 2006-01-19
1649257031 Scott D Rubin Physician Assistant 3400 Main Street, Springfield, MA 01107-1113 2005-12-27
Find all providers in SPRINGFIELD

Competitor

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City SPRINGFIELD
Zip Code 97477

Improve Information

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Dataset Information

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.

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