Individual
JORDAN MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(541) 561-8737
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(541) 561-8737
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/27/2016
Last updated
01/21/2021
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