Individual
MINDY MILAR MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
7975 SW 83RD AVE, PORTLAND, OR 97223-7334
(888) 667-6467
(888) 667-6467
Mailing address
8959 SW BARBUR BLVD STE 115, PORTLAND, OR 97219-4032
(888) 667-6467
(888) 667-6467
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
50112NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500623422
—
OR
01
—
50112NP
OREGON BOARD OF NURSING
—
Enumeration date
02/26/2008
Last updated
02/07/2019
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