Jeremy Moore, aaot
Counselor in Portland, OR. Individual provider (NPI-1).
NPI number1760633622
StatusActive
Last updated in NPPESOct 8, 2008
Details
- NPI
- 1760633622
- Entity type
- Individual (NPI-1)
- Name
- Jeremy Moore
- Credential
- aaot
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 8, 2008
- Last updated
- Oct 8, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
3550 Se Woodward StPortland, OR 97202-1552
Phone 503-517-8663 · Fax 503-943-4994
Mailing address
740 Ne 53rd Ave Apt 33Portland, OR 97213-3164
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