Individual
ANN MARIE MOYLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1717 NE 42ND AVE STE 3100, PORTLAND, OR 97213-1572
(503) 567-5103
Mailing address
1717 NE 42ND AVE STE 3100, PORTLAND, OR 97213-1572
(503) 567-5103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6126
NE
1041C0700X
Clinical Social Worker
Primary
15431
OR
Other
Enumeration date
06/09/2021
Last updated
01/07/2025
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