Suzanne Michelle Moore

NPI 1467608083 - Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities - 320900000X

NPI Details
NPI 1467608083
Gender Female
Enumeration Date 08/14/2008
Last Updated 07/29/2010
Entity Type Individual
Active Over 8 years ago
Practice Location
722 NE 162ND AVE
PORTLAND OR, 97230-5760, US
Phone (503) 515-5566
Fax (503) 261-0988
Business Location
PORTLAND OR, 97211-1132, US
Phone (503) 302-9258
Taxonomy Code 320900000X
License State Oregon
License Number SM1219
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According to our database, Suzanne Michelle Moore NPI is 1467608083, taxonomy code is 320900000X and license number is SM1219, license state is located at Oregon. Suzanne Michelle Moore physically located at 722 Ne 162nd Ave, Portland OR, 97230-5760. NPI Number Suzanne Michelle Moore has the Individual type.

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1467608083 NPI number is provided on an as is basis without warranty of any kind. 1467608083 is maintained by the National Plan & Provider Enumeration System. The contents of Suzanne Michelle Moore are for informational purposes only.