Individual
ANGELO DOMINGO MOLLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
5725 NE PRESCOTT ST, PORTLAND, OR 97218-2275
(503) 402-8101
(503) 249-9510
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
01/27/2021
Last updated
10/09/2025
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