Individual
MRS. RHONDA ROSEANNE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8643 NE BEECH ST, PORTLAND, OR 97220-5012
(503) 256-2151
Mailing address
8643 NE BEECH ST, PORTLAND, OR 97220-5012
(503) 256-2151
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1030077
OR
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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