Individual
MR. JOSEPH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10202 SE 32ND AVE STE 701, MILWAUKIE, OR 97222-3625
(503) 496-3201
Mailing address
5415 SW WESTGATE DR, PORTLAND, OR 97221-2409
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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