Active NPI
Victoria Grace Mosse, MA, ATC,PTA
- Athletic Trainer
- Portland, OR
National Provider Identifier
1104807585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-AT 503236
- Practice address
- 1620 SE Ankeny St
Portland, OR 97214-1448 - Phone
- (503) 546-0620
- Fax
- (503) 546-0620
- NPI assigned
- Nov 10, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-AT 503236 | OR | Primary |
Addresses
Primary practice location
1620 SE Ankeny St
Portland, OR 97214-1448
Mailing address
7108 N Ivanhoe St
Portland, OR 97203-3943
Phone (503) 289-6361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT-AT 503236 | OR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104807585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 N IVANHOE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972033943",
"telephone_number": "503-289-6361",
"fax_number": "503-546-0620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 SE ANKENY ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972141448",
"telephone_number": "503-546-0620",
"fax_number": "503-546-0620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSSE",
"first_name": "VICTORIA",
"middle_name": "GRACE",
"name_prefix": "Ms.",
"credential": "MA, ATC,PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OR",
"license": "AT-AT 503236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.