Individual
MRS. TASHA ANN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
707 NW EVERETT ST, PORTLAND, OR 97209-3517
(503) 222-4906
(503) 222-3215
Mailing address
7112 NE 94TH AVE, VANCOUVER, WA 98662-3836
(360) 566-5065
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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