Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Russell Moss

Individual provider Social Worker · NPI 1053621912

Jacob Russell Moss is a Social Worker in Portland, Oregon. Registered with an NPI since 2010.

In the registry since
2010

Practice location Address checks out

12636 SE Stark St Plaza 125 Bldg J
Portland, OR 97233-1058
Phone: (503) 253-4600
Fax: (503) 253-4609
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X

Record details

NPI number1053621912
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 13, 2010
Last updated in NPPESJuly 24, 2014

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